78 - Stomach cancer

Summary

This is a subcategory of All cancer deaths (see Map 7).

The stomach is part of the digestive system. See also Map 71 Cancer of gullet, Map 72 Pancreatic cancer, Map 74 Rectal cancer and Map 79 Colon cancer.

There is generally a north–south divide, with the area south of a line drawn from the Severn to the Wash having lower rates, apart from London. There is a cluster of particularly high rates in Stoke-on-Trent, with Glasgow, other northern urban areas and the south Wales valleys also having high rates. The correlation between poverty and dying from this form of cancer is high enough for it in many cases to mark out the poorer quarters of particular towns and cities on this map.

Stomach cancer is more common in people with poor diets and high alcohol and tobacco consumption. Rates have fallen in recent decades. This is thought to be related to falling rates of Helicobacter pylori (H pylori) infection. Changes in diet, in particular the refrigeration of food, and eating less pickled and smoked food, may also play a role. Other factors which increase the risk of stomach cancer are pernicious anaemia and atrophic gastritis (a stomach disorder).

H pylori is an infection of the stomach and duodenum that as well as causing stomach cancer can lead to gastritis, peptic ulcers and duodenitis. It was a common infection but rates have fallen for each successive birth cohort over the past several decades. Once you have the infection, untreated it usually stays with you for life, but infected people often have no symptoms before getting the conditions listed above.

High levels of H pylori infection have been found to be associated with living in poor socioeconomic conditions and poverty during childhood; children who live in poverty are therefore more likely to get stomach cancer later in life (see ‘Introduction’ in G. Davey Smith (2003) Health inequalities: Lifecourse approaches, Bristol: The Policy Press).

Writer Gertrude Stein,actor John Wayne, footballer and manager Brian Clough and Prime Minister Neville Chamberlain died from this cause.