Gastric cancer: Overview

Source: Correa P. (2013). Gastric cancer: Overview. Gastroenterol Clin North Am. 42(2):211-7. doi: 10.1016/j.gtc.2013.01.002. Epub 2013 Feb 21. PMID:23639637; PMCID: PMC3995345

Summary: Gastric cancer is the second leading cause of cancer-related deaths worldwide. Therefore, this review focuses on providing a comprehensive understanding of the causes and treatment of gastric cancer. This review also focuses specifically on adenocarcinomas as they account for approximately 90% of all gastric cancer cases.

The odds of survival after being diagnosed with adenocarcinoma are extremely low with a 5-year survival rate of under 20%. To increase the odds of survival, early detection programs need to be implemented. One of the reasons gastric cancer is so deadly is that it is usually asymptomatic or has nonspecific symptoms until later stages when it has spread and become harder to treat. Alternatively, early detection will enable for quick and immediate treatment, reducing the spread of the disease and increasing the likelihood of survival. However, few countries have set up adequate early detection programs. Nevertheless, on a more optimistic note, gastric cancer rates are decreasing. The primary reasons for the decrease in gastric cancer cases are changes in diet (the increased intake of fresh fruits and vegetables and reduced salt consumption) and refrigeration (safer and healthier foods) and a decrease in tobacco use

The primary cause of gastric cancer is infection. While diet and food intake can affect one’s likelihood of getting gastric cancer and can also cause gastric cancer, infection is still the primary root of the disease. More specifically, H Pylori is the most common type of infection. This infection is often acquired in infancy and, if not treated in infancy, remains for life. It significantly increases the likelihood of one developing gastric cancer.

To prevent gastric cancer, strategies focus on eliminating H pylori. Antibiotics are often employed to treat H Pylori. Currently, the main focus in trying to reduce the rate of gastric cancer caused by H Pylori is to employ better methods for early detection. Research is currently underway to detect blood-based biomarkers to detect people at high risk for gastric cancer which will help ensure early and quick treatment, reducing the death rate of the disease. Another focus to prevent gastric cancer is to encourage a change in dietary habits by increasing the consumption of fresh fruits and vegetables and reducing salt intake.

Implications: While gastric cancer is deadly, we can reduce the frequency with which the disease is developed. The main risk factors for the disease are dietary habits and infection. By encouraging a change in the foods one consumes and employing early detection methods for the disease, we can continue to reduce the number of people with the disease. Future efforts should focus on education and advocacy to communicate to people the importance of eating healthy with fruits and vegetables and the specific types of foods to avoid consuming, like those high in salt. Continued research on biomarkers and screenings to elucidate early detection methods is also essential in preventing the progression of infection that can potentially lead to gastric cancer.