Increasing incidence of adenocarcinoma of the proximal stomach

A retrospective study was performed on patients with histologically proven gastric adenocarcinoma during the periods 1972 to 1976 (n = 368) and 1986 to 1990 (n = 870) to analyse the potential changes in tumour distribution within the stomach. A recent increase in gastric cancer patients admitted to our institution represents a change in the referral patterns of the patients. The mean age and male:female ratio according to site distribution of the tumour were not found to differ between the two periods. The proportion of carcinomas of the upper third of the stomach was, however, significantly increased (P less than 10(-6)) in the recent series (36.4%) compared with the old series (20.6%). Since the incidence of gastric cancer in our population seems to be unchanged, this may suggest a true increase in proximal gastric tumours. The data may indicate possible changes in aetiological influences.