The National Cancer Data Base report on gastric cancer

Previous Commission on Cancer studies from the National Cancer Data Base (NCDB) have examined time trends in stage of disease, treatment patterns, and survival for selected cancers. The most current (1991) data for gastric cancer are described here.

Three Calls for Data have yielded a total of 16,992 case reports of gastric cancer for 1985, 1986, and 1991, from hospital cancer registries across the U.S.

Gastric cancer was the 15th most frequent cancer reported to the NCDB. The proportion of all reported cancers that were gastric in the two time intervals studied were essentially the same. In 1991, 20.8% of the cases were reported in minorities. Only 46% of gastric cancer cases were staged by the American Joint Committee on Cancer (AJCC) system in 1985 to 86, compared with 77% in 1991. More advanced stages were reported for younger patients, but less advanced stages were noted in the Asian population. Of all patients reported, 41.4% had no reported cancer-directed surgery, 41.1% had partial or hemigastrectomy, and 6.7% had total gastrectomy. More extensive surgery was associated with patients with Stage III disease than with Stages I and II, as might be expected. Survival after treatment remained poor (5-year relative survival; 43% for Stage I, 37% for Stage II, 18% for Stage III, and 20% for Stage IV).

Improvements in treatment will emerge allowing survival to serve as a better guide for the quality of care in the future. In the interim, the frequency of American Joint Committee on Cancer staging in patient charts and the fraction of patients with Stages I and II as opposed to Stages III and IV disease (as a measure of prompt diagnosis) may serve as measure of how quickly these cancers are being diagnosed.