Cancer Information

Stomach Cancer

Gastric cancer is currently estimated to be the thirteenth most common cancer and the eighth most deadly in the United States. There has been a steady decline in the incidence since 1930, when it was the number one cancer killer comprising 38% of all cancer deaths. It is of interest that this reduction in incidence has not occurred in all countries, and, despite some reasonable dietary hypotheses (such as change in methods of food preservation, increasing intake of Vitamin C, and “inadvertent” antibiotic control of Helicobacter pylori infection) this decline has not been the result of any planned health promotion or prevention intervention. Although the etiology of gastric cancer is uncertain, chronic atrophic gastritis is considered a predisposing factor, and there is circumstantial evidence for the role of nitrosamine production from dietary nitrate ingestion. Adenomatous polyps in the stomach have an association with gastric cancer but these are too infrequent to be a common precancerous lesion. Chronic peptic ulcer is clearly not a precancerous state despite the gross presentation of some gastric cancers as “ulcero-cancers.”

A trend in gastric cancer presentation over the last few decades has been a shift in the anatomic location of the primary lesion. There has been a change from predominately distal gastric cancers to a greater frequency of lesions arising in the proximal stomach. Another trend in the last few decades has been an increase in incidence of primary gastric lymphoma (non-Hodgkin’s lymphoma). However, 90% of gastric cancers are still adenocarcinomas.