Gastric Cancer: How Can We Reduce the Incidence of this Disease?

Caroline M Den Hoed,Ernst J Kuipers

doi:10.1007/s11894-016-0506-0

Abstract

Gastric cancer remains a prevalent disease worldwide with a poor prognosis. Helicobacter pylori plays a major role in gastric carcinogenesis. H. pylori colonization leads to chronic gastritis, which predisposes to atrophic gastritis, intestinal metaplasia, dysplasia, and eventually gastric cancer. Screening, treatment, and prevention of H. pylori colonization can reduce the incidence of gastric cancer. Other interventions that may yield a similar effect, although of smaller magnitude, include promotion of a healthy lifestyle including dietary measures, non-smoking, low alcohol intake, and sufficient physical activity. This chapter reviews interventions that can lead to a decline in gastric cancer incidence in high and low incidence countries.

Highlights

Despite its declining incidence, gastric cancer is still the fourth most common malignancy and remains the third leading cause of cancer-related death, following lung and liver cancer [1]
This pathway starts with chronic active gastritis leading to gland loss and development of atrophic gastritis, intestinal metaplasia, and dysplasia to eventually result in gastric adenocarcinoma
H. pylori eradication treatment resulted in a statistically significant reduction in incidence of gastric cancer (HR 0.56, 95 % CI 0.34–0.91) and a non-significant reduction in gastric cancer mortality (HR 0.63, 95 % CI 0.29– 1.37) in patients with intestinal metaplasia or dysplasia at baseline. These findings suggested that H. pylori eradication treatment is effective for prevention of cancer in subjects with intestinal metaplasia and dysplasia [16]

Summary

Introduction

Gastric cancer is still the fourth most common malignancy and remains the third leading cause of cancer-related death, following lung and liver cancer [1]. There are marked differences within many geographic areas, with considerably higher gastric cancer incidences among indigenous populations [3]. Most cases of gastric cancer are intestinal-type adenocarcinomas and the majority is localized in the antrum and body of the stomach. The decrease in prevalence of H. pylori significantly contributed to the declining incidence of gastric cancer in many parts of the world. The annual numbers of patients diagnosed with and dying from gastric cancer remained to increase till in particular due to the growing population in areas with high H. pylori prevalence [5]. Risk modulators are in particular related to lifestyle The recognition of these risk modulators determines the options for prevention and intervention to decrease the incidence of gastric cancer

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Conclusions

Findings

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