Discussion
The CIRs and ASIRs of GC cases among the Saudi population must be
tracked and kept current for all Saudi regions. The purpose of this
study was to investigate the CIR and ASIR patterns of GC in Saudi Arabia
from 2004 to 2017. According to the PubMed database, this is the first
descriptive epidemiological research on the spatial/temporal
distribution of GC among men and women in different regions of Saudi
Arabia. It explores the actual state of the GC trend and the relevance
of the disease in the population of Saudi Arabia.
From 2004 to 2017, the overall number of GC cases among Saudi men and
women was 175 and 110 (7.1%), respectively. In addition, the overall
number of confirmed cases of GC between 2004 and 2017 by age group of
Saudi males and females were recorded, as the disease occurred in a
significant percentage among those aged 50 years and older (Male:
83.3%, Female: 70.9%), whereas the age group younger than or equal to
49 years was less affected by GC (Male: 16.7%, Female: 29.0%). These
findings are similar with those of other studies indicating that the
median age of diagnosis for GC is 72 years old and that roughly 10% of
gastric carcinomas are diagnosed in patients 45 years of age or
younger.10-12
In this study, the incidence of GC was observed to be higher in males
than in females. From 2004 to 2017, the CIR and ASIR of GC were twofold
greater in Saudi men than in women. Globally, the incidence of GC varies
by sex and geographical location. It is more prevalent in men than in
women, and the risk of developing it rises with age.13In the United States, the recent studies indicates that the most major
risk factor for the development of GC is male gender, with a ratio 2:1
male to female predominance.14 As well as, in the
developed countries, men are 2,2 times more likely than women to be
diagnosed with GC.15 Therefore, other studies indicate
that male gender is a significant predictor of GC. In addition, Yang et
al.16 found in their research of the survival rates of
patients with metastatic GC that male patients had poorer survival rates
than female patients.
In Saudi Arabia, the ASIR trend of GC among Saudi men and women has
dropped steadily from 2004 to 2017. Similarly, over the past several
decades, the incidence rates of GC have decreased gradually throughout
the majority of the world including the United States (Figure 7).1 &17 Increasing hygienic standards, enhanced food
preservation, increased intake of fresh fruits and vegetables, and
Helicobacter pylori eradication could explain this downward
trend.1&18
Our results indicates that male and female Saudis in Riyadh, Najran, and
the Eastern region had the highest overall ASIRs for GC from 2004 to
2017. This suggests that males and females in Riyadh, Najran, and the
Eastern region of Saudi Arabia are exposed to a significant risk factor
for GC. In contrast, men and women in Jazan, Saudi Arabia, were the
least affected by GC, indicating that they were more exposed to GC
protective factor than persons in other regions of Saudi Arabia.
However, a further epidemiological study should be conducted in the
region of Riyadh, Najran, and Eastern region to find out the potential
risk factors that lead to the increase of ASIR of GC among Saudis men
and women. Furthermore, the protective factors of GC in the Jazan region
that contributed to the lower rates of GC, should be investigated.
In Saudi Arabia, the estimated ASIR for GC among both genders in 2020
was 2.7% per 100,000 people. The rate is significantly lower compared
to other countries. Oman had the highest rate of GC among both genders
in the Arabian Gulf, at 8.0 per 100,000 people; this rate was 2.9 times
greater than Saudi Arabia
(Figure
8). Furthermore, the ASMR of GC was observed in Saudi Arabia at a rate
of 2.1 per 100,000 people among both sexes. Compared to other Arab
countries, this mortality rate was slightly lower
(Figure
9). However, Oman had the greatest ASMR of GC among both genders, at
6.9 per 100,000 people, which was 3.2 times greater than Saudi Arabia.
The results of this study also indicate that the overall ASIR of GC is
extremely low in Saudi Arabia compared to Mongolia (32.5 per 100,000
people), Japan (31.6 per 100,000 people), and Korea (27.7 per 100,000
people); these rates were 9 to 10 times higher than in Saudi Arabia.9
This study investigates the actual distribution of GC in Saudi Arabia.
It helps other researchers in formulating a new hypothesis regarding the
potential risk-protective factors of GC among male and female Saudis
residing in different regions. However, these studies have some
limitations, including the absence of a comparison group and the
inability to evaluate the statistical association between
factors.19 In this research, the average death rates
of GC in various regions of Saudi Arabia could not be determined since
the SCR reports lacked information on the number of GC-related deaths.