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Globally, gastric cancer remains the fifth most common cancer and the third leading cause of cancer-related mortality.
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In the United States, despite overall decreasing rates over the past five decades, incidence of noncardia gastric cancer is increasing among adults less than 50 years.
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Helicobacter pylori is the main cause of gastric cancer, accounting for approximately 89% of distal gastric cancer cases worldwide.
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Population-based programs of screening and surveillance and H pylori screening and
Gastric Cancer Epidemiology
Section snippets
Key points
Worldwide Trends
According to GLOBOCAN estimates, there were 1,033,701 new cases of gastric cancer worldwide and 782,685 deaths related to gastric cancer in 2018.3 Gastric cancer was the fifth-most commonly diagnosed cancer type in 2018 (representing 5.7% of all cancer cases diagnosed) and was responsible for 8.2% of all deaths from cancer in 2018, making it the third-most common cause of cancer-related death after lung (18.4% of deaths) and colorectal (9.2% of deaths) cancers.3 In 2018, the global
Helicobacter pylori Infection
Chronic infection with H pylori is the main cause of gastric cancer, accounting for approximately 89% of distal gastric cancer cases worldwide.18 In 1994, the International Agency for Research on Cancer classified H pylori as a class I carcinogen for noncardia gastric cancer and reconfirmed this classification in 2009.19 Most H pylori infections are acquired during childhood and, once established, usually persist for life unless treated. There is substantial regional variation in prevalence,20
Prevention
Gastric cancer maintains a high case fatality rate of 75% throughout most of the world56 and is a main contributor to global disability-adjusted life-year burden.57 Mass screening for gastric cancer is generally not included in national strategies for cancer prevention because of high cost; decreasing incidence; and a lack of data on whom, when, and how to screen. To date, the clinical practice of gastric cancer prevention has focused on screening and surveillance and H pylori screening and
Future directions
Biomarkers for screening and risk triaging and clinical prediction rules that combine these biomarkers with established clinical and lifestyle factors for risk stratification need to be derived, optimized, and then validated in external populations. Future biomarker studies should aim to state the a priori plan for building statistical models; consider interactions, transformations, and splines; refrain from categorizing predictors; use and report model coefficients; aim for external
Summary
Further improvements in screening, treatment, and early diagnosis are needed for gastric cancer, which remains the third most common cause of cancer-related mortality worldwide. Although mass screening strategies could be beneficial, current modalities are not yet readily implementable in organized screening settings. Conversely, because the population risk (based on histology) can change rapidly, and H pylori eradication is effective, population-based programs of screening and treatment of H
Clinics care points
Although rates of noncardia gastric cancer in the United States continue to decrease among adults aged ≥50 years, the incidence of noncardia gastric cancer among persons aged less than 50 years is increasing, particularly among Hispanics, non-Hispanic Blacks, and Asian and Pacific Islanders. Chronic infection with H pylori is the main cause of gastric cancer, accounting for approximately 89% of distal gastric cancer cases worldwide, and data demonstrate that eradicating H pylori reduces the
Disclosure
The authors have nothing to disclose.
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2023, MicronCitation Excerpt :Gastric cancer is a major global health problem, and in its early stages, surgical resection may be curative, but many gastric cancer cases are found in their advanced stages with poor survival rates (Hsu and Raufi, 2021; Kim and Cho, 2021; Inoue, 2021; Cavatorta et al., 2018; Kong et al., 2022; Wang et al., 2021; He et al., 2021; Chen et al., 2021). Epidemiological studies have identified major contributors to gastric cancer, including the increasing of age, male sex, helicobacter pylori infection and smoking (Thrift and Nguyen, 2021; Koseki et al., 2021). Therefore, it is of great significance to find out specific drugs for the treatment of gastric cancer to replace chemotherapy, and to further evaluate the therapeutic effects and side effects of drugs on the human body.