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Sex/Gender-Specific Medicine for Intestinal-Type and Diffuse-Type Gastric Cancer

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Book cover Sex/Gender-Specific Medicine in the Gastrointestinal Diseases

Abstract

The Lauren classification, which is the most widely used system of categorizing gastric cancer (GC), divides GC into two types: the intestinal type and the diffuse type. These two types of GC differ in their endoscopic and histological features, as well as their epidemiology, cause, and prognosis. Diffuse-type GC is more common among females and younger individuals, and although it is strongly associated with Helicobacter pylori (H. pylori), it is more strongly influenced by genetic than by environmental factors. A higher prevalence of GC in males than in females can be observed throughout the world, but younger patients with GC are more likely to be female, have the diffuse and undifferentiated types, and present with advanced GC (AGC). Older patients with GC are more likely to be male, have the intestinal type, and present with simultaneous tumors. A multivariate analysis of the risk factors of diffuse-type GC found that female sex, age under 50, and AGC were independent risk factors. Family history of GC and smoking have been added as risk factors after analyzing patients with GC since 2013. In females, the diffuse type accounts for most cases before menopause, but the proportion of the intestinal- type becomes similar to that in males 10 years after menopause, indicating that female sex hormones suppress the incidence of intestinal-type GC. Serum pepsinogen II and H. pylori positivity, which had an odds ratio of 21 for early-stage diffuse-type GC among females younger than 40 in South Korea, can be used as important biomarkers for the diagnosis of GC.

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  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)

    Nayoung Kim

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Kim, N. (2022). Sex/Gender-Specific Medicine for Intestinal-Type and Diffuse-Type Gastric Cancer. In: Kim, N. (eds) Sex/Gender-Specific Medicine in the Gastrointestinal Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-19-0120-1_10

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