• Miodrag M Stojanovic, Natasa K Rancic, Marija R Andjelkovic Apostolovic, Aleksandra M Ignjatovic, and Mirko V Ilic.
• Institute for Public Health, Faculty of Medicine, University of Nis, 18000 Nis, Serbia.
• Medicina (Kaunas). 2021 Jun 28; 57 (7).

AbstractSomach cancer is the third most common cause of cancer-related deaths worldwide. The objective of the paper was to analyze the incidence and mortality trends of stomach cancer in Central Serbia in the period between 1999-2017. Materials and Methods: trends and annual percentage change (APC) of the incidence and mortality rate with corresponding 95% confidence intervals (CI) were calculated by joinpoint regression analyses. The optimal number of Joinpoints was identified using the Monte Carlo permutation method. The trend was considered to be significantly increasing (positive change) or decreasing (negative change) when the p-value was below 0.05 (p < 0.05). Results: the total number of new cases was 16,914 (10,873 males and 6041 females) and the total number of mortality cases was 14,790 (9348 in and 5442 in females). Almost one third (30.8%) of new cases were registered in the 60-69-year age group, and new cases were significantly more frequent in males than in females (30.8% vs. 29.02%, p < 0.001). Joinpoint regression analysis showed a significant decrease of incidence trend in females during the 2000-2015 period with APC of -2.13% (95% CI: -3.8 to -0.5, p < 0.001). An insignificant decrease in incidence trend was in males with APC of -0.72% (95% CI: -2.3 to 0.9, p = 0.30). According to the joinpoint analysis, a significant decrease of mortality trends both in males during 2000-2015 with APC of -2.21% (95% CI: -1.6 to -7.5, p ≤ 0.001 and in females, during the same period, with APC of -1.75% (95% CI: -2.9 to -0.6, p < 0.001) was registered. From 2015 to 2017, a significant increase of mortality was registered with APC of 44.5% (95% CI: from 24.2 to -68.1, p ≤ 0.001) in females and in males with APC of 53.15% (95% CI: 13.5 to -106.6, p ≤ 0.001). Conclusion: a significant decrease of stomach cancer incidence trend in females and insignificant decrease of incidence trend in males were determined in Central Serbia. Based on presented results, the mortality trend decreased significantly both in males and in females during 2000-2015, and from 2015 to 2017 we recorded a significant increase in mortality in both sexes. We found significantly more new cases in women than in men in the age group of 40-49, and the mortality of stomach cancer was significantly more frequent among females compared to males in the age groups 30-39, as well as in the 50-59 age group. There is a need for improving recording and registration of new cases of stomach cancer, especially in females. Urgent primary and secondary preventive measures are needed-introducing stomach cancer screening and early detection of premalignant changes. Urgent primary and secondary preventive measures are needed.

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