|LETTER TO THE EDITOR
|Year : 2013 | Volume
| Issue : 2 | Page : 61
Estrogen's protective affect for gastric cancer?
Thomas Iain Lemon, Annabelle Lee
Instiute of Medical Education School of Medicine, Cardiff University, Cardiff, United Kingdom
|Date of Submission||17-Jun-2013|
|Date of Acceptance||23-Jan-2014|
|Date of Web Publication||11-Jul-2014|
Thomas Iain Lemon
Instiute of Medical Education School of Medicine, Cardiff University, Cardiff
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Lemon TI, Lee A. Estrogen's protective affect for gastric cancer?. Int J Stud Res 2013;3:61
López-Basave et. al. novel study  investigated the specific clinical and pathological outcomes of patients under the age of 30 with gastric cancer. They conclude there is a different pattern in the younger cohort and highlight the late diagnosis of the disease in this cohort. The well-constructed conclusion has two points of interest to us: firstly the signet ring histology and secondly the gender similarity.
The gender equality is interesting, as estrogen was previously thought to protect women from gastric cancer and a ratio of 3:1 (male:female) is often cited in non-age banded cohorts  . If this study was to be reproduced, this should be a central area, as this may suggest estrogen protection is time cumulative and hence one may be able to give synthetic estrogen in earlier life to those found to have Helicobacter pylori or other risk factors as prophylaxis. It could also suggest the sex ratio is actually considerably more than 3:1 and hence a study looking at a cohort over the age of 30 for sex prevalence would be worthwhile.
Signet ring histology is commonly associated with a worse prognosis  , so the presence in younger patients is noteworthy, supporting the authors comment that diagnosis is later in the under 30s.
The authors correctly discuss the reduced environmental factors due to age, although, there is of course the unproved but noteworthy suggestion of food causes, particularly smoked foods. Furthermore, smoking increases the risk of gastric cancer (presenting in the upper esophagus). As such any further studies would benefit from filtering people with these possible contacts.
Whilst the usual concerns over a small cohort should be stated, this study has highlighted an important possibility that requires rigorous work. We congratulate the authors and hope further work is carried out into the potential that estrogen's protection against gastric cancer is cumulative and hence inducible synthetically.
| References|| |
|1.||Lopez-Basave HN, Morales-Vasquez F, Ruiz-Molina JM, et. al. Gastric cancer in young people under 30 years of age: worse prognosis, or delay in diagnosis? Cancer Manag Res 2013;5:31-6. |
|2.||Chandanos E. Estrogen in the development of esophageal and gastric adenocarcinoma . Doctoral Thesis. Sweden: Karolinska Institutet; 2007. |
|3.||Lee WS, Chun HK, Lee WY, et. al. Treatment outcomes in patients with signet ring cell carcinoma of the colorectum. Am J Surg 2007;194(3):294-8. |