Stomach cancer | |
---|---|
Other names | Gastric cancer |
A stomach ulcer that was diagnosed as cancer on biopsy and surgically removed | |
Specialty | Gastroenterology Oncology |
Symptoms | Early: Later: |
Usual onset | Over years[2] |
Types | Gastric carcinomas, lymphoma, mesenchymal tumor[2] |
Causes | Helicobacter pylori, genetics[2][3] |
Risk factors | Smoking, dietary factors such as pickled vegetables, obesity[2][4] |
Diagnostic method | Biopsy done during endoscopy[1] |
Prevention | Mediterranean diet, not smoking[2][5] |
Treatment | Surgery, chemotherapy, radiation therapy, targeted therapy[1] |
Prognosis | Five-year survival rate: < 10% (advanced cases),[6] 32% (US),[7] 71% (Japan)[8] |
Frequency | 968,350 (2022)[9] |
Deaths | 659,853 (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]