Stomach cancer

Stomach cancer
Other namesGastric cancer
A stomach ulcer that was diagnosed as cancer on biopsy and surgically removed
SpecialtyGastroenterology Oncology
SymptomsEarly: Later:
Usual onsetOver years[2]
TypesGastric carcinomas, lymphoma, mesenchymal tumor[2]
CausesHelicobacter pylori, genetics[2][3]
Risk factorsSmoking, dietary factors such as pickled vegetables, obesity[2][4]
Diagnostic methodBiopsy done during endoscopy[1]
PreventionMediterranean diet, not smoking[2][5]
TreatmentSurgery, chemotherapy, radiation therapy, targeted therapy[1]
PrognosisFive-year survival rate:
< 10% (advanced cases),[6]
32% (US),[7] 71% (Japan)[8]
Frequency968,350 (2022)[9]
Deaths659,853 (2022)[9]

Stomach cancer, also known as gastric cancer, is a cancer that develops from the lining of the stomach.[10] Most cases of stomach cancers are gastric carcinomas, which can be divided into a number of subtypes, including gastric adenocarcinomas.[2] Lymphomas and mesenchymal tumors may also develop in the stomach.[2] Early symptoms may include heartburn, upper abdominal pain, nausea, and loss of appetite.[1] Later signs and symptoms may include weight loss, yellowing of the skin and whites of the eyes, vomiting, difficulty swallowing, and blood in the stool, among others.[1] The cancer may spread from the stomach to other parts of the body, particularly the liver, lungs, bones, lining of the abdomen, and lymph nodes.[11]

The most common cause is infection by the bacterium Helicobacter pylori, which accounts for more than 60% of cases.[2][3][12] Certain strains of H. pylori have greater risks than others.[2] Smoking, dietary factors such as pickled vegetables and obesity are other risk factors.[2][4] About 10% of cases run in families, and between 1% and 3% of cases are due to genetic syndromes inherited such as hereditary diffuse gastric cancer.[2] Most of the time, stomach cancer develops in stages over years.[2] Diagnosis is usually by biopsy done during endoscopy.[1] This is followed by medical imaging to determine if the disease has spread to other parts of the body.[1] Japan and South Korea, two countries that have high rates of the disease, screen for stomach cancer.[2]

A Mediterranean diet lowers the risk of stomach cancer, as does not smoking.[2][5] Tentative evidence indicates that treating H. pylori decreases the future risk.[2][5] If stomach cancer is treated early, it can be cured.[2] Treatments may include some combination of surgery, chemotherapy, radiation therapy, and targeted therapy.[1][13] For certain subtypes of gastric cancer, cancer immunotherapy is an option as well.[14] If treated late, palliative care may be advised.[2] Some types of lymphoma can be cured by eliminating H. pylori.[15] Outcomes are often poor, with a less than 10% five-year survival rate in the Western world for advanced cases.[6] This is largely because most people with the condition present with advanced disease.[6] In the United States, five-year survival is 31.5%,[7] while in South Korea it is over 65% and Japan over 70%, partly due to screening efforts.[2][8]

Globally, stomach cancer is the fifth-leading type of cancer and the third-leading cause of death from cancer, making up 7% of cases and 9% of deaths.[16] In 2018, it newly occurred in 1.03 million people and caused 783,000 deaths.[17] Before the 1930s, it was a leading cause of cancer deaths in the Western world, however rates have sharply declined among younger generations in the West, while they remain high for people living in East Asia.[18][19][20] The decline in the West is believed to be due to the decline of salted and pickled food consumption, as a result of the development of refrigeration as a method of preserving food.[21] Stomach cancer occurs most commonly in East Asia, followed by Eastern Europe.[2] It occurs twice as often in males as in females.[2]

  1. ^ a b c d e f g h i "Gastric Cancer Treatment (PDQ®)". NCI. 17 April 2014. Archived from the original on 5 July 2014. Retrieved 1 July 2014.
  2. ^ a b c d e f g h i j k l m n o p q r s t "5.4 Stomach Cancer". World Cancer Report 2014. 2014.
  3. ^ a b Chang AH, Parsonnet J (October 2010). "Role of bacteria in oncogenesis". Clinical Microbiology Reviews. 23 (4): 837–857. doi:10.1128/CMR.00012-10. PMC 2952975. PMID 20930075.
  4. ^ a b González CA, Sala N, Rokkas T (September 2013). "Gastric cancer: epidemiologic aspects". Helicobacter. 18 (Suppl 1): 34–38. doi:10.1111/hel.12082. PMID 24011243. S2CID 22918077.
  5. ^ a b c "Stomach (Gastric) Cancer Prevention (PDQ®)". NCI. 27 February 2014. Archived from the original on 4 July 2014. Retrieved 1 July 2014.
  6. ^ a b c Orditura M, Galizia G, Sforza V, Gambardella V, Fabozzi A, Laterza MM, et al. (February 2014). "Treatment of gastric cancer". World Journal of Gastroenterology. 20 (7): 1635–1649. doi:10.3748/wjg.v20.i7.1635. PMC 3930964. PMID 24587643.
  7. ^ a b "Cancer of the Stomach - Cancer Stat Facts". SEER. Retrieved 1 February 2020.
  8. ^ a b "がん診療連携拠点病院等院内がん登録生存率集計: [国立がん研究センター がん登録・統計]". ganjoho.jp. Retrieved 2 February 2020.
  9. ^ a b Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. (4 April 2024). "Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries". CA: A Cancer Journal for Clinicians. doi:10.3322/caac.21834. ISSN 0007-9235.
  10. ^ "Stomach (Gastric) Cancer". NCI. January 1980. Archived from the original on 4 July 2014. Retrieved 1 July 2014.
  11. ^ Ruddon RW (2007). Cancer biology (4th ed.). Oxford University Press. p. 223. ISBN 978-0-19-517543-1. Archived from the original on 15 September 2015.
  12. ^ Sim F, McKee M, eds. (2011). Issues in public health (2nd ed.). Open University Press. p. 74. ISBN 978-0-335-24422-5.
  13. ^ Wagner AD, Syn NL, Moehler M, Grothe W, Yong WP, Tai BC, et al. (August 2017). "Chemotherapy for advanced gastric cancer". The Cochrane Database of Systematic Reviews. 2017 (8): CD004064. doi:10.1002/14651858.cd004064.pub4. PMC 6483552. PMID 28850174.
  14. ^ Kodach LL, Peppelenbosch MP (August 2021). "Targeting the Myeloid-Derived Suppressor Cell Compartment for Inducing Responsiveness to Immune Checkpoint Blockade Is Best Limited to Specific Subtypes of Gastric Cancers". Gastroenterology. 161 (2): 727. doi:10.1053/j.gastro.2021.03.047. PMID 33798523.
  15. ^ Stathis A, Bertoni F, Zucca E (September 2010). "Treatment of gastric marginal zone lymphoma of MALT type". Expert Opinion on Pharmacotherapy. 11 (13): 2141–2152. doi:10.1517/14656566.2010.497141. PMID 20586708. S2CID 6796557.
  16. ^ Stewart BW, Wild C, et al. (International Agency for Research on Cancer) (2014). "1.1 The global and regional burden of cancer". World Cancer Report 2014. World Health Organization. ISBN 978-92-832-0429-9.
  17. ^ Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (November 2018). "Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries". CA: A Cancer Journal for Clinicians. 68 (6): 394–424. doi:10.3322/caac.21492. PMID 30207593. S2CID 52188256.
  18. ^ Tobias SJ, Hochhauser D, Souhami RL (2010). Cancer and its management (6th ed.). Wiley-Blackwell. p. 259. ISBN 978-1-4443-0637-8.
  19. ^ Khleif RT, Skeel SN, eds. (2011). Handbook of cancer chemotherapy (8th ed.). Wolter Kluwer. p. 127. ISBN 978-1-60831-782-0.
  20. ^ Knight JA (2010). Human Longevity: The Major Determining Factors. Author House. p. 339. ISBN 978-1-4520-6722-3. Archived from the original on 16 September 2015.[self-published source?]
  21. ^ Moore RJ, Spiegel D, eds. (2004). Cancer, culture, and communication. Kluwer Academic. p. 139. ISBN 978-0-306-47885-7.

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