Pattern of gastric cancer in Iraq

Background. Gastric cancer is the fourth most common cancer in the world. In this research project, we tried to touch this important topic and find out where we stand in regard to this cancer with its relatively poor prognosis and lack of response to treatment. The study aimed to determine the gastric cancer pattern, and risk factors in Iraqi population. Materials and methods. Of the approachable regions with trustable data collection, we chose two regions: Sulaymaniyah and its renowned Hiwa Cancer Center and Babylon to comprehensively study demography, clinical presentations, prevalence, tumor type, site and stage of the disease, body mass index and adverse past medical history. Socioeconomic status and education level were also taken into consideration. Diet type, saltiness, spiciness and temperature association was critically analyzed. Blood group, family history, smoking habit and alcohol consumption were also recorded. Results. A total of 150 patients with gastric cancer were involved in this study. Male to female ratio was 1.3 : 1. The median ages of male and female were 61 and 52 years, respectively. The tumor distribution by anatomical site was as follows: the lesion was distal in 83 (55 %) patients, proximal in 26 (17 %), involved the body and fundus in 16 (11 %), the entire stomach in 12 (8 %). In 13 (9 %) of cases, lesser curve was the site. The commonest histologic subtype was adenocarcinoma of the intestinal type in 69 patients (46 %). Diffuse type was seen in only 43 (29 %) patients, 14 (9 %) had mixed and in 24 (16 %), the histopathology was unclassifiable. Ulcerative lesion was reported in 57 % of cases. Polypoid or fungating lesions were found in 28 % and infiltrative in 15 %. The commonest endoscopic finding was ulcerative type seen in 57 % of patients. Most of the gastric carcinoma cases (44 %) fell in stage IV disease. Among people with stage IV, only 11 have Her-2 status, negative in 10 cases (15.15 %) and positive in only one patient. The commonest site for metastases was in the liver followed by peritoneum. Conclusions. Despite its low incidence, some epidemiological features of gastric cancer in Iraq mimic those of the high-risk countries. Adenocarcinoma accounts for the highest number of gastric cancers. Most patients are in their 5 and 6 decades of life. The incidence of gastric carcinoma in patients younger than 50 years is higher than in the Western world. Compared to Western literature, our patients were presenting more with intestinal-type adenocarcinoma and less with diffuse type. Most patients had advanced stages of the disease.