Stomach cancer primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Parminder Dhingra, M.D. [2] Mohammed Abdelwahed M.D[3]

Stomach cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Stomach Cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Endoscopy and Biopsy

Chest X Ray

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Stomach cancer primary prevention On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Stomach cancer primary prevention

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Stomach cancer primary prevention

CDC on Stomach cancer primary prevention

Stomach cancer primary prevention in the news

Blogs on Stomach cancer primary prevention

Directions to Hospitals Treating Stomach cancer

Risk calculators and risk factors for Stomach cancer primary prevention

## Overview

[edit | edit source]

Effective measures for the primary prevention of stomach cancer include smoking cessation, eradication of Helicobacter pylori infection, and having a balanced diet rich in fruits and vegetables. In areas of low gastric cancer, incidence and screening for gastric cancer with upper endoscopy should be reserved for specific high-risk subgroups. Individuals at increased risk for gastric cancer include gastric adenomas, pernicious anemia, gastric intestinal metaplasia, familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome, Juvenile polyposis syndrome.

## Primary prevention

[edit | edit source]

### Lifestyle modifications

[edit | edit source]

Lifestyle modifications include following:[1]

* Dietary modification is an important approach to control gastric cancer. There is a link between physical inactivity and obesity to many types of cancer.
* Diet with low consumption of red meat, high in fruits and vegetables may have a protective effect against many cancers.
* The World Health Assembly adopted the WHO Global Strategy on Diet, Physical Activity, and Health, in May 2004 to reduce deaths and diseases.

### H.pylori eradication

[edit | edit source]

* The incidence of metachronous gastric cancer following the endoscopic resection of a gastric neoplasm is known to be reduced by the eradication of H. pylori infection. [1][2]

## Prevention Through Screening

[edit | edit source]

* In countries with a high incidence of gastric cancer such as east Asia countries, universal screening is recommended
* Japan has a high incidence of gastric cancer; therefore annual screening via double contrast barium radiography and photofluorography every year or upper endoscopy every two to three years [3]
* Screening interval is recommended to be every two years but may be extended to a three-year interval without significant difference in effect[3]

## Prevention of Hereditary Cancer

[edit | edit source]

### Prevention

[edit | edit source]

* Asymptomatic patients with a family history of HDGC and CDH1 mutations have a high probability of developing signet ring cell adenocarcinoma of the stomach. Prophylactic total gastrectomy is recommended for patients with family history of HDGC and CDH1 mutations.[4][5]

* For patients with a CDH1 mutation but who are not from an HDGC family, individualized evaluation at an experienced center before prophylactic total gastrectomy is recomended.[6]

* Prophylactic gastrectomy is often advised between age 20 and 30.
* Some suggest timing total gastrectomy in CDH1 mutation carriers at an age that is five years younger than the youngest family member who developed gastric cancer.[7]
* Older patients are less likely to benefit from a prophylactic gastrectomy than younger patients because of a shorter life-expectancy and a higher perioperative risk.[5]

* Patients who are older than 75 years should not undergo such a procedure, as their mortality from the procedure outweighs their mortality from gastric cancer.
* Decisions should be individualized based upon their comorbidities and the age of gastric cancer onset in their respective kindred.[8]

## References

[edit | edit source]

1. ↑ 1.0 1.1 Park JY, von Karsa L, Herrero R (November 2014). "Prevention strategies for gastric cancer: a global perspective". Clin Endosc. 47 (6): 478–89. doi:10.5946/ce.2014.47.6.478. PMC 4260094. PMID 25505712.
2. ↑ García Martín R, Matía Cubillo Á (May 2016). "[INFLUENCE OF DIET IN PRIMARY PREVENTION OF GASTRIC CANCER, IN PATIENTS INFECTED WITH HELICOBACTER PYLORI]". Rev Enferm (in Spanish; Castilian). 39 (5): 33–8. PMID 27405145.CS1 maint: Unrecognized language (link)
3. ↑ 3.0 3.1 Ohata H, Oka M, Yanaoka K, Shimizu Y, Mukoubayashi C, Mugitani K, Iwane M, Nakamura H, Tamai H, Arii K, Nakata H, Yoshimura N, Takeshita T, Miki K, Mohara O, Ichinose M (October 2005). "Gastric cancer screening of a high-risk population in Japan using serum pepsinogen and barium digital radiography". Cancer Sci. 96 (10): 713–20. doi:10.1111/j.1349-7006.2005.00098.x. PMID 16232204.
4. ↑ Keller G, Vogelsang H, Becker I, Hutter J, Ott K, Candidus S; et al. (1999). "Diffuse type gastric and lobular breast carcinoma in a familial gastric cancer patient with an E-cadherin germline mutation". Am J Pathol. 155 (2): 337–42. doi:10.1016/S0002-9440(10)65129-2. PMC 1866861. PMID 10433926.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
5. ↑ 5.0 5.1 Abreu E (1997). "[Primary prevention and detection of gastric cancer]". Cad Saude Publica (in Portuguese). 13 Suppl 1: 105–108. PMID 10886930. Vancouver style error: initials (help)CS1 maint: Unrecognized language (link)
6. ↑ Pharoah PD, Guilford P, Caldas C, International Gastric Cancer Linkage Consortium (2001). "Incidence of gastric cancer and breast cancer in CDH1 (E-cadherin) mutation carriers from hereditary diffuse gastric cancer families". Gastroenterology. 121 (6): 1348–53. PMID 11729114.CS1 maint: Multiple names: authors list (link)
7. ↑ Norton JA, Ham CM, Van Dam J, Jeffrey RB, Longacre TA, Huntsman DG; et al. (2007). "CDH1 truncating mutations in the E-cadherin gene: an indication for total gastrectomy to treat hereditary diffuse gastric cancer". Ann Surg. 245 (6): 873–9. doi:10.1097/01.sla.0000254370.29893.e4. PMC 1876967. PMID 17522512.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
8. ↑ Chun YS, Lindor NM, Smyrk TC, Petersen BT, Burgart LJ, Guilford PJ; et al. (2001). "Germline E-cadherin gene mutations: is prophylactic total gastrectomy indicated?". Cancer. 92 (1): 181–7. PMID 11443625.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)

Template:WH Template:WS