[Trends in gastric cancer incidence, mortality and survival in the Umbria region of Italy. 1978-82 and 1994-99].

Gastric cancer, despite the decrease observed in the last 50 years, is yet the fourth cause of death for malignant tumor in Italy. Data from the Registro Tumori Umbro di Popolazione have been used to assess incidence, mortality and survival rates for this cancer over the period 1994-1999. The results have been compared with the data of an ad hoc study realized in the period 1978-1982 and with the ones of the other population-based cancer registries. Mortality and incidence rates are among the highest in Italy, confirming the existence of a high risk area for gastric cancer in central Italy; anyway, both mortality and incidence decrease during the study period. Also survival rates from gastric cancer recorded in Umbria over the period 94-99 were among the highest respect to other Italian cancer Registries. A case-control study carried out in a neighbouring area, aimed to explain the elevated incidence of gastric cancer, found that the consumption of a "traditional" diet--rich in proteins (particularly from sausages), nitritis and nitrous compound, alcohol, coffee, and fibres--was an important risk factor for gastric cancer. Survival over the period 94-99 is significantly improved, if compared to 1979-82 survival rate. The high survival rate recorded in the Umbria region could be related both to the number of cases treated in Umbria and to the quality of the regional oncologic system; in fact, in Umbria we reported high survival rates for several malignancies.