Should I be worried about stomach cancer?

While stomach (or gastric) cancer is the fourth most common cancer globally (it is the most common cancer in China and nearly half of global cases occur there), it is much less common in developed countries, including the US (where it is not in the ten most common cancer diagnoses). Stomach cancer constitutes less than 2% of cancer cases diagnosed in the US. The absolute risk of stomach cancer in the US is quite low with approximately 5 cases per 100,000 individuals (in contrast with colon cancer where the incidence is approximately 45 cases per 100,000 individuals).

Global rates of stomach cancer in 2002, females & males; maps courtesy of IARC (click on each to enlarge)

What are risk factors for stomach cancer?
The leading cause of stomach cancer is infection with helicobacter pylori (H pylori), a bacteria. Rates of H pylori infection have declined significantly in developed countries, contributing to the decline in stomach cancer rates. Also contributing to the decline in the developed world is the use of refrigeration (instead of salt) to reserve foods, significantly reducing individual salt intake. Salt and salty food intake are likely causes of stomach cancer. There is also good evidence that intake of non-starchy (e.g. green leafy vegetables, tomatoes) and allium (i.e. onions and garlic) vegetables reduce risk of stomach cancer. Evidence also indicates that a high intake of fruit protects against stomach cancer. As with many cancers, tobacco use is a clear risk factor for stomach cancer.

Can I get tested for stomach cancer?
There is currently no good screening test for stomach cancer. Unfortunately, stomach cancer often shows no outward signs or symptoms in the early stages. However, if you experience any of the following, you should talk with your doctor:

  • Indigestion or a burning sensation (heartburn)
  • Discomfort or pain in the abdomen
  • Nausea or vomiting
  • Diarrhea or constipation
  • Bloating of the stomach after meals
  • Loss of appetite
  • Weakness and tiredness
  • Vomiting blood

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