There are pronounced global epidemiological variations in gastric cancer, with a higher incidence in East Asia, Eastern Europe, and South America, compared with the rest of the world.[4] It is more common in men than in women. The annual incidence per 100,000 population in Japanese men is about 80, Japanese women 30, British men 18, British women 10, white American men 11, and white American women 7.[5] Incidence has declined dramatically in North America, Australia, and New Zealand since 1930, but the decline in Europe has been slower.[6] The American Cancer Society estimated that 26,240 new patients would be diagnosed with gastric cancer in the US in 2018.[7] The incidence of gastric cancer has decreased 4-fold in the US since 1930,[4] which has been attributed to better food preparation and refrigeration. However, while there has been a decrease in distal gastric cancers, there has been a marked increase in proximal gastric and gastro-oesophageal junction cancers, especially among white males, for reasons that are not entirely clear. Gastric cancer occurs twice as frequently in men as in women and is more common in older people.[8][9] African-American, Hispanic, and American-Indian people are twice as likely to develop gastric cancer as white people in the US.[10]

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