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Histologic classification of gastric carcinoma in Hawaii Japanese by the Lauren System confirms the observations of others that the intestinal type is associated with better survival experience and is more common in men and older people than is diffuse carcinoma. This study also indicates that women with diffuse carcinoma exhibit better long-term survival rates than men with diffuse carcinoma. This difference can be explained by less frequent lymph node metastases in women with diffuse tumors. The known differences in the sex distribution of stomach cancer survival and mortality rates in Japanese as compared with Caucasians; the predilection of diffuse carcinomas to occur in young women; and the differences in survival of men and women with diffuse carcinoma suggest that inherited hormonal and immunologic factors might influence the growth of this tumor.
Stemmermann et al. (Mon,) studied this question.