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Microsoft word - forman.docForman, David
Epidemiology of gastric carcinoma.
Abstract for presentation at Porto meeting – 27th April 2006-04-03
Professor of Cancer Epidemiology
University of Leeds,
Worldwide, there are currently over 900000 new diagnoses of gastric cancer each year
making this the 3rd and 5th most common form of cancer in males and females respectively. There is a ten-fold variation in incidence between the highest and lowest risk populations and rates are notably high in East Asia, South America and Eastern Europe. Incidence rates in most populations have been declining substantially over several decades. Gastric cancer arising in the proximal cardia region of the stomach has been reported, however, to show different trends from that of the disease in the distal stomach. This form of the cancer maybe increasing in incidence in some populations and it also has a different geographical distribution and a higher male to female incidence ratio compared with distal cancer. Classification problems and variation in recording practice complicate accurate reporting of cardia cancer. The main identified environmental risk factors for gastric cancer are various dietary exposures and Helicobacter pylori infection. Of the former, much evidence relates increased consumption of fruit and vegetables to a decreased risk of gastric cancer although more recent prospective studies are failing to confirm this relationship. There is no evidence that vitamin supplementation reduces the risk of gastric cancer. Although much research has been carried out into the role of dietary salt and nitrate intake and alcohol consumption in the aetiology of gastric cancer there is no clear consensus about the importance of these risk factors. H. pylori infection has been associated with at least a six-fold risk of cancer although there is now evidence that the risk is substantially higher. It is, therefore, becoming necessary to interpret the role of other risk factors, alongside that of H. pylori, and to investigate whether they help determine which H. pylori infected subjects proceed along the carcinogenic pathway. Curriculum Vitae
David Forman- biography
David Forman studied biology for his first degree at Keele University and subsequently
undertook a PhD at Southampton University. He had postdoctoral appointments at the
University of Glasgow and with the Imperial Cancer Research Fund (ICRF) in Mill
Hill. While there, he developed an interest in cancer epidemiology and in 1982 moved
to the ICRF Epidemiology Unit in Oxford, under the directorship of the late Sir Richard
Doll. He remained in Oxford for 12 years becoming a Principal Research Scientist with
ICRF and a Research Fellow at Green College.
In 1994 Professor Forman took up his present post as Professor of Cancer Epidemiology
at the University of Leeds. He is also Director at the Northern and Yorkshire Cancer
Registry and currently chairs the UK Association of Cancer Registries.
Professor Forman’s main research interests have been concerned with the aetiology of
gastro-intestinal cancers, especially stomach cancer, and with trends in the incidence
and management of cancers. During the last decade, he has been involved in developing
the discipline of cancer care epidemiology: population-based research into the delivery
of effective cancer care. He is the author of over 150 research papers and is also Co-
ordinating Editor for the Cochrane Collaboration Group in Upper Gastro-intestinal and
Pancreatic Diseases. In 2001, he was elected as one of the first non-clinical Fellows of
the U.K. Faculty of Public Health Medicine.
Selected recent publications:
Wu AH, Crabtree JE, Bernstein L, Hawtin P, Cockburn M, Tseng CC, Forman D.
(2003) Role of Helicobacter pylori CagA+ strains and risk of adenocarcinoma of the
stomach and esophagus. International Journal of Cancer 103:815-21.
Barrett JH, Smith G, Waxman R, Gooderham N, Lightfoot T, Garner RC,
Augustsson K, Wolf CR, Bishop DT, Forman D and the Colorectal Cancer Study
Group. (2003) Investigation of interaction between N-acetyltransferase 2 and
heterocyclic amines as potential risk factors for colorectal cancer. Carcinogenesis
Moayyedi P, Soo S, Deeks J, Forman D, Harris A, Innes M, Delaney B. (2003)
Systematic review: Antacids, H2-receptor antagonists, prokinetics, bismuth and
sucralfate therapy for non-ulcer dyspepsia. Alimentary Pharmacology and Therapeutics
Forman D, Stockton D, Møller H, Quinn M, Babb P, De Angelis R, Micheli A.
(2003) Cancer prevalence in the United Kingdom: results from the EUROPREVAL
Study. Annals of Oncology 14:648-54.
Verdecchia A, Corazziari I, Gatta G, Lisi D, Faivre J, Forman D. (2004) Explaining
gastric cancer survival differences among European countries. International Journal of
Cancer 109: 737-41.
Turner F, Smith G, Sachse C, Lightfoot T, Garner RC, Wolf CR, Forman D,
Bishop DT, Barrett JH (on behalf of the Colorectal Cancer Study Group). (2004)
Vegetable, fruit and meat consumption and potential risk modifying genes in relation to
colorectal cancer. International Journal of Cancer 112:259-264.
Ford A, Delaney BC, Forman D, Moayyedi P. (2004) Eradication therapy in
Helicobacter pylori positive peptic ulcer disease: Systematic review and economic
analysis. American Journal of Gastroenterology 99: 1833-55.
Rapley EA, Hockley S, Warren W, Johnson L, Huddart R, Crockford G, Forman D et al
(2004) Somatic mutations of KIT in familial testicular germ cell tumours. British of Journal of
Ford A, Forman D, Reynolds PD, Cooper BT, Moayyedi P. (2005) Ethnicity, gender,
and socioeconomic status as risk factors for esophagitis and Barrett's esophagus.
American Journal of Epidemiology 162:454-60.
McGreavey LE, Turner F, Smith G, Boylan K, Bishop DT, Forman D, Wolf CR,
Barrett JH and the Colorectal Cancer Study Group. (2005) No Evidence that
polymorphisms in CYP2C8, CYP2C9, UGT1A6, PPARd and PPARg act as
modifiers of the protective effect of regular NSAID use on the risk of colorectal
carcinoma. Pharmocogenetics and Genomics 15:713-721.
Moayyedi P, Forman D, Duffett S, Mason S, Brown J, Crocombe W,
Feltbower R, Axon A on behalf of the Leeds HELP study group. (2005) The
association between Helicobacter pylori infection and adult height. European Journal of
Cook MB, Wild CP, Forman D (2005) A systematic review and meta-analysis of the
sex ratio for Barrett's esophagus, erosive reflux disease, and nonerosive reflux disease.
American Journal of Epidemiology. 162:1050-61.
Ford AC, Forman D, Bailey AG, Axon AT, Moayyedi P (2005) A community
screening program for Helicobacter pylori saves money: 10-Year follow-up of a
randomized controlled trial. Gastroenterology. 129:1910-17.
Du Y, Agnew A, Ye XP, Robinson PA, Forman D, Crabtree JE (2006) Helicobacter
pylori and Schistosoma japonicum co-infection in a Chinese population: helminth
infection alters humoral responses to H. pylori and serum pepsinogen I/II ratio.Microbes
and Infection. 8:52-60
Julie Bruno, AAHPM Director of Education, started the morning plenary session with a reminder that “life happens” at preconference workshops just as it does in real life, so one of the session speakers had to attend to a family health matter. The schedule was therefore rearranged a bit to provide the two remaining faculty time to cover the additional lectures. The speakers are experts and