Current issues in gastric cancer epidemiology.

Gastric cancer, one of the most common malignant tumors of digestive tract continues to be a major health problem by frequency, aggressiveness and low rate of cure in symptomatic stage. Although its incidence is decreasing (especially in the West), globally the gastric cancer is ranked fourth in incidence among cancers at various sites. Despite these developments, the gastric cancer mortality, overall declining globally, is high. especially in the West where even if diagnosed fewer cases of gastric cancer, TNM stages are advanced and have a poor prognosis. In contrast, in Japan, where the incidence is still high, the percentage of cases diagnosed at the stage of "early gastric cancer" has greatly increased, thus improving prognosis. Gastric neoplasia affects more men, age range 50-70 years, disadvantaged social classes and black race. In Romania the gastric cancer incidence is increasing over recent years, presenting variations across the country being more common in men compared with women, reaching a peak of incidence around age 60. Gastric cancer mortality in the world places Romania among the countries with average mortality. Gastric cancer prognosis remains extremely reserved, in close correlation with tumor stage at diagnosis, surgical treatment being the only possibility to provide improved survival, especially in the early stages. Improvement of survival rate in recent years is due to increased gastric resectability result of an earlier diagnosis, a more complex treatment and a closer monitoring of the population at risk.