GASTRIC CARDIA CANCER; THE MOST COMMON TYPE OF UPPER GASTROINTESTINAL CANCER IN ARDABIL, IRAN: AN ENDOSCOPY CLINIC EXPERIENCE

Background-According to a recent report published by the Ministry of Health and Medical Education of the I. R. of Iran, gastric cancer (GC) is the most common fatal cancer in this country and its prevalence is highest in Ardabil province, Northwest of Iran. This descriptive endoscopic survey was designed to determine the type of upper gastrointestinal (GI) malignancy in this high prevalence area. Method-This study was conducted in the first established subspeciality outpatient GI clinic in the city of Ardabil. From 11,518 patients who attended this clinic in a one-year period, 1,152 (10%) with persistent upper GI symptoms underwent upper GI fiberoptic endoscopy and 162 (14.1%) had a tumor with malignant appearance. At least six endoscopic punch biopsies were obtained from all the tumors and sent for histopathologic examination. Demographic data was obtained from all 162 patients. Statistical analysis was performed using the SPSS statistical software. Results-The mean age of the patients with cancer was 63.5 ± 10.8 years and the male to female ratio was 2.14:1. Villagers constituted 111 (70.7%) and urban dwellers constituted 46 (29.3%) patients. Upper GI cancer was diagnosed by histopathology in 157 patients (13.4%). Stomach cancer constituted 107 cases (68.2%), 53 (49.5%) of which were cancers of the gastric cardia and 50(31.8%) were esophageal cancer. The most common site of upper GI malignancy was the gastric cardia 53 (33.8%) followed by the antrum 32(20.4%), esophageal body 27 (17.2%), distal esophagus 23 (14.6%), and gastric body 22 (14.0%). Conclusion-Cancer of the gastric cardia is now the most common upper GI malignancy in Ardabil and constitutes almost half of all gastric cancers. It is recommended that subsitespecific gastric cancer risk factors, including H. pylori and dietary nitrates, be studied in the future in this region.