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Résumé (français)

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Résumé (anglais)

Introduction: Gastric cancer (GC) is one of the deadliest diseases as most of the cases are diagnosed at late stages, thereby making treatment almost impossible. GC incidence in North America has been reported to be decreasing over the years. Nevertheless, the primary concern is whether the decrease is valid for all communities? Purpose and Objectives: The purposeof this study is to identify high-risk GC hotspots in Manitoba andinvestigate factors associated with GC in Manitoba. The objectives wereto (1) describe and investigate the geographical variation of GC incidence in Manitoba; (2) explore factors influencing the geographic change of GC incidence in Manitoba, and (3) investigate the geographical variation of GC incidence over time in Manitoba. Methods: This research study adopted anecological design. A spatial Poisson regression model was used to address research objectives (1) and (2), and a Spatio-temporal Poisson regression model was used to address research objective 3. Results: SESI wassignificantly associated with cardia gastric cancer (CGC) and marginally associated with non-cardia gastric cancer (NCGC), while the Indigenous population proportion was marginally associated with CGC. In specific, 1 unit increase in SESI reduces the risk of CGC by 14% (IRR= 0.859; 95% CI: 0.780-0.947) and the risk of NCGC by approximately 10% (IRR = 0.898; 95% CI: 0.812 -0.995); 1% increase in regional Indigenous population proportion reduces the risk of CGC by 1.4% (IRR = 0.986; 95% CI: 0.978 -0.994). Also, 1 unit increase in SESI reduces the risk of CGC among women by 26.2% (IRR = 0.738; 95% CI: 0.618-0.879), and a 1% increase in Indigenous population proportion reduces the risk of CGC among women by 1.9% (IRR = 0.981; 95% CI: 0.966-0.996). Conclusion: This study has demonstrated the existence of regional variation of GC incidence risk with temporal pattern in Manitoba.