{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T01:50:44Z","timestamp":1781142644224,"version":"3.54.1"},"reference-count":50,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T00:00:00Z","timestamp":1555286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Canadian Institutes for Health Research","award":["MOP115031"],"award-info":[{"award-number":["MOP115031"]}]},{"DOI":"10.13039\/501100000145","name":"Alberta Innovates - Health Solutions","doi-asserted-by":"publisher","award":["201201159"],"award-info":[{"award-number":["201201159"]}],"id":[{"id":"10.13039\/501100000145","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>In northern Canada where there is a high prevalence of Helicobacter pylori infection, there is a paucity of information on gastric cancer by the topographical subsites cardia (CGC) and non-cardia (NCGC). Here we describe the incidence of CGC and NCGC, separately, among northern Canadian populations. We used data from the Cancer Incidence in Five Continents Volumes X (CI5X) and XI (CI5XI) to obtain CGC and NCGC incidence for Canada and for Yukon (YT), a northern Canadian territory. Using these data with those provided by the Government of the Northwest Territories (NT), we estimated standardized incidence ratios comparing northern populations to Canada as a whole. We also estimated age-standardized incidence rates to permit comparisons across populations globally. NT and YT populations were disproportionately impacted by gastric cancer, particularly NCGC. This was especially true for Indigenous populations: NCGC incidence rates among NT Indigenous men were 2.7 times the rates among all men in Canada, while rates among NT Indigenous women were 3.1 times the rates among all women in Canada. Similarly, age-standardized rates of NCGC among Indigenous NT residents were comparable to global regions where there is a high burden of NCGC. This study has, for the first time, quantified the incidence of CGC and NCGC for the NT and YT, providing new insights into the burden of these cancers among northern Canadian populations.<\/jats:p>","DOI":"10.3390\/cancers11040534","type":"journal-article","created":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T11:15:58Z","timestamp":1555326958000},"page":"534","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Gastric Cancer in Northern Canadian Populations: A Focus on Cardia and Non-Cardia Subsites"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1077-5427","authenticated-orcid":false,"given":"Amy","family":"Colquhoun","sequence":"first","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Hannah","sequence":"additional","affiliation":[{"name":"Department of Health and Social Services, Government of the Northwest Territories, Yellowknife, NT X1A 2L9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Corriveau","sequence":"additional","affiliation":[{"name":"Department of Health and Social Services, Government of the Northwest Territories, Yellowknife, NT X1A 2L9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Hanley","sequence":"additional","affiliation":[{"name":"Department of Health and Social Services, Government of Yukon, Whitehorse, YT Y1A 1Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2073-9924","authenticated-orcid":false,"given":"Yan","family":"Yuan","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3790-3217","authenticated-orcid":false,"given":"Karen J.","family":"Goodman","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada"},{"name":"Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2E1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The CANHelp Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1136\/gutjnl-2014-308915","article-title":"Global patterns of cardia and non-cardia gastric cancer incidence in 2012","volume":"64","author":"Colquhoun","year":"2015","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/hel.12082","article-title":"Gastric Cancer: Epidemiologic Aspects","volume":"18","author":"Sala","year":"2013","journal-title":"Helicobacter"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1158\/1055-9965.EPI-13-1057","article-title":"Gastric cancer: Descriptive epidemiology, risk factors, screening, and prevention","volume":"23","author":"Karimi","year":"2014","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"The EUROGAST Study Group (1993). An international association between Helicobacter pylori infection and gastric cancer. Lancet, 341, 1359\u20131362.","DOI":"10.1016\/0140-6736(93)90938-D"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1002\/ijc.28999","article-title":"Global burden of gastric cancer attributable to Helicobacter pylori","volume":"136","author":"Plummer","year":"2015","journal-title":"Int. J. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"354","DOI":"10.3748\/wjg.v12.i3.354","article-title":"Epidemiology of gastric cancer","volume":"12","author":"Crew","year":"2006","journal-title":"World J. Gastroenterol. WJG"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"6329","DOI":"10.1038\/sj.onc.1207726","article-title":"International variation","volume":"23","author":"Parkin","year":"2004","journal-title":"Oncogene"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S1470-2045(12)70137-7","article-title":"Global burden of cancers attributable to infections in 2008: A review and synthetic analysis","volume":"13","author":"Ferlay","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1038\/bjc.1990.129","article-title":"Poor housing in childhood and high rates of stomach cancer in England and Wales","volume":"61","author":"Barker","year":"1990","journal-title":"Br. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/oxfordjournals.epirev.a036288","article-title":"The decline in gastric cancer: Epidemiology of an unplanned triumph","volume":"8","author":"Howson","year":"1986","journal-title":"Epidemiol. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1093\/ije\/30.1.181","article-title":"The epidemiological enigma of gastric cancer rates in the US: Was grandmother\u2019s sausage the cause?","volume":"30","author":"Paik","year":"2001","journal-title":"Int. J. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/S1535-6108(04)00033-9","article-title":"Focus on gastric cancer","volume":"5","author":"Ushijima","year":"2004","journal-title":"Cancer Cell"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1136\/gutjnl-2013-305033","article-title":"The burden of stomach cancer in indigenous populations: A systematic review and global assessment","volume":"63","author":"Arnold","year":"2014","journal-title":"Gut"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1016\/S1470-2045(15)00232-6","article-title":"Cancer incidence in indigenous people in Australia, New Zealand, Canada, and the USA: A comparative population-based study","volume":"16","author":"Moore","year":"2015","journal-title":"Lancet Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Young, T.K., Kelly, J.J., Friborg, J., Soininen, L., and Wong, K.O. (2016). Cancer among circumpolar populations: An emerging public health concern. Int. J. Circumpolar Health, 75.","DOI":"10.3402\/ijch.v75.29787"},{"key":"ref_17","unstructured":"Department of Health and Social Services, Government of the Northwest Territories (2003). Cancer in the Northwest Territories, 1990\u20132000. A Descriptive Report."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1002\/cncr.21542","article-title":"Incidence of esophageal and gastric carcinomas among American Asians\/Pacific Islanders, whites, and blacks: Subsite and histology differences","volume":"106","author":"Wu","year":"2006","journal-title":"Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1158\/1055-9965.EPI-09-0250","article-title":"Stomach carcinoma incidence patterns in the United States by histologic type and anatomic site","volume":"18","author":"Wu","year":"2009","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e003689","DOI":"10.1136\/bmjopen-2013-003689","article-title":"Disease manifestations of Helicobacter pylori infection in Arctic Canada: Using epidemiology to address community concerns","volume":"4","author":"Cheung","year":"2014","journal-title":"BMJ Open"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"606","DOI":"10.4161\/19490976.2014.969639","article-title":"Community-driven research on environmental sources of H. pylori infection in arctic Canada","volume":"5","author":"Hastings","year":"2014","journal-title":"Gut Microbes"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1002\/ijc.11502","article-title":"Cancer in Greenlandic Inuit 1973\u20131997: A cohort study","volume":"107","author":"Friborg","year":"2003","journal-title":"Int. J. Cancer"},{"key":"ref_23","first-page":"30","article-title":"Cancer in Alaska Native people, 1969\u20132003","volume":"48","author":"Lanier","year":"2006","journal-title":"Alaska Med."},{"key":"ref_24","unstructured":"Health Standards, Quality and Performance Division, Analytics and Performance Reporting Branch (2018). Stomach Cancer Incidence among First Nations in Alberta, First Nations\u2014Health Trends Alberta."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"210","DOI":"10.5694\/j.1326-5377.2005.tb06668.x","article-title":"Prevalence of Helicobacter pylori in Indigenous Western Australians: Comparison between urban and remote rural populations","volume":"182","author":"Windsor","year":"2005","journal-title":"Med. J. Aust."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1111\/hel.12186","article-title":"Trends in Helicobacter pylori infection among M\u0101ori, Pacific, and European Birth cohorts in New Zealand","volume":"20","author":"McDonald","year":"2015","journal-title":"Helicobacter"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1017\/S0950268815001181","article-title":"The diagnosis and treatment of Helicobacter pylori infection in Arctic regions with a high prevalence of infection: Expert Commentary","volume":"144","author":"McMahon","year":"2016","journal-title":"Epidemiol. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1002\/cncr.23732","article-title":"Gastric cancer among American Indians and Alaska Natives in the United States, 1999\u20132004","volume":"113","author":"Wiggins","year":"2008","journal-title":"Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1111\/j.1572-0241.2004.04131.x","article-title":"Marked Multi-Ethnic Variation of Esophageal and Gastric Cardia Carcinomas within the United States","volume":"99","author":"Kubo","year":"2004","journal-title":"Am. J. Gastroenterol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S1055-3207(02)00002-9","article-title":"Epidemiologic trends in esophageal and gastric cancer in the United States","volume":"11","author":"Brown","year":"2002","journal-title":"Surg. Oncol. Clin. N. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1093\/ije\/25.5.941","article-title":"Trends in incidence rates of adenocarcinoma of the oesophagus and gastric cardia in New Zealand, 1978\u20131992","volume":"25","author":"Armstrong","year":"1996","journal-title":"Int. J. Epidemiol."},{"key":"ref_32","first-page":"571","article-title":"Anatomy of the stomach","volume":"32","author":"Mahadevan","year":"2014","journal-title":"Surg. Oxf. Int. Ed."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1093\/jnci\/djx262","article-title":"The Changing Face of Noncardia Gastric Cancer Incidence Among US Non-Hispanic Whites","volume":"110","author":"Anderson","year":"2018","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1093\/aje\/kwm051","article-title":"A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes","volume":"165","author":"Freedman","year":"2007","journal-title":"Am. J. Epidemiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1038\/sj.bjc.6604880","article-title":"Non-steroidal anti-inflammatory drugs and risk of gastric and oesophageal adenocarcinomas: Results from a cohort study and a meta-analysis","volume":"100","author":"Abnet","year":"2009","journal-title":"Br. J. Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2319","DOI":"10.1093\/annonc\/mdr615","article-title":"Red and processed meat consumption and the risk of esophageal and gastric cancer subtypes in The Netherlands Cohort Study","volume":"23","author":"Keszei","year":"2012","journal-title":"Ann. Oncol."},{"key":"ref_37","unstructured":"Szklo, M., and Nieto, J. (2014). Epidemiology: Beyond the Basics, Jones & Bartlett Learning. [3rd ed.]."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1093\/pubmed\/23.1.40","article-title":"Why do we continue to use standardized mortality ratios for small area comparisons?","volume":"23","author":"Julious","year":"2001","journal-title":"J. Public Health Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2","DOI":"10.24095\/hpcdp.35.S1.02","article-title":"Cancer incidence in Canada: Trends and projections (1983\u20132032)","volume":"35","author":"Xie","year":"2015","journal-title":"Health Promot. Chronic Dis. Prev. Can."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1002\/(SICI)1097-0142(19981115)83:10<2049::AID-CNCR1>3.0.CO;2-2","article-title":"Changing patterns in the incidence of esophageal and gastric carcinoma in the United States","volume":"83","author":"Devesa","year":"1998","journal-title":"Cancer"},{"key":"ref_41","first-page":"669","article-title":"Trends in incidence of oesophageal and stomach cancer subtypes in Europe","volume":"22","author":"Steevens","year":"2010","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.canep.2013.11.001","article-title":"Trend breaks in incidence of non-cardia gastric cancer in the Netherlands","volume":"38","author":"Holster","year":"2014","journal-title":"Cancer Epidemiol."},{"key":"ref_43","unstructured":"Government of Canada, S.C. (2018, May 30). Aboriginal Peoples Highlight Tables, 2016 Census. Available online: http:\/\/www12.statcan.gc.ca\/census-recensement\/2016\/dp-pd\/hlt-fst\/abo-aut\/Table.cfm?Lang=Eng&T=101&S=99&O=A."},{"key":"ref_44","unstructured":"Forman, D., Bray, F., Brewster, D., Gombe Mbalawa, C., Kohler, B., Pineros, M., Steliarova-Foucher, E., Swaminathan, R., and Ferlay, J. (2014, July 06). Cancer Incidence in Five Continents, Vol. X (Electronic Version). Available online: http:\/\/ci5.iarc.fr."},{"key":"ref_45","unstructured":"Bray, F., Colombet, M., Mery, L., Pineros, M., Znaor, A., Zanetti, R., and Ferlay, J. Cancer Incidence in Five Continents, Vol. XI, International Agency for Research on Cancer. Available online: http:\/\/ci5.iarc.fr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/apm.1965.64.1.31","article-title":"The two histological main types of gastric carcinoma: Diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification","volume":"64","author":"Lauren","year":"1965","journal-title":"Acta Pathol. Microbiol. Scand."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Rothman, K.J., Greenland, S., and Lash, T.L. (2008). Precision and Statistics in Epidemiologic Studies. Modern Epidemiology, Wolters Kluwer.","DOI":"10.1016\/S0169-7161(07)27003-8"},{"key":"ref_48","unstructured":"Rothman, K.J. (2012). Random Error and the Role of Statistics. Epidemiology: An Introduction, Oxford University Press."},{"key":"ref_49","unstructured":"Segi, M. (1960). Cancer Mortality for Selected Sites in 24 Countries (1950\u20131957), Department of Public Health, Tohoku University School of Medicine."},{"key":"ref_50","unstructured":"SAS Institute Inc (2017). The STDRATE Procedure. SAS\/STAT(R) 14.3 User\u2019s Guide, SAS Institute Inc."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/11\/4\/534\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:45:25Z","timestamp":1760186725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/11\/4\/534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,15]]},"references-count":50,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,4]]}},"alternative-id":["cancers11040534"],"URL":"https:\/\/doi.org\/10.3390\/cancers11040534","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,15]]}}}