Gastric cancer is a type of malignant tumor that originates from the epithelial cells of the stomach and is the most prevalent form of gastrointestinal cancer. In our country, the incidence is higher in the northern regions compared to the south, and coastal areas tend to have higher rates than inland regions. Men are more commonly affected than women, with the 40–60 age group being the most vulnerable. The exact cause of gastric cancer remains unclear, but it is believed that dietary factors play a significant role. Consuming moldy or spoiled food, pickled vegetables, smoked or salted fish, and excessive amounts of salt may increase the risk of developing this disease. On the other hand, eating more fresh fruits, vegetables, and proteins can help reduce the risk.
Chronic stomach conditions, such as chronic gastritis or previous partial stomach surgery, along with the presence of large amounts of bacteria in the stomach, may contribute to the development of cancer by enhancing the effects of carcinogens. Helicobacter pylori infection is also strongly associated with the development of gastric cancer. Additionally, genetic factors can predispose individuals to this condition, making some people more susceptible due to inherited traits.
There are five known precancerous lesions that may lead to gastric cancer:
1. Chronic atrophic gastritis with intestinal metaplasia and atypical hyperplasia
2. Adenomatous polyps
3. Residual gastritis
4. Pernicious anemia with marked hypotonia of the stomach body
5. A small number of patients with gastric ulcers
Early-stage gastric cancer often presents no symptoms and may go unnoticed. Some individuals might experience mild digestive discomfort. However, in advanced stages, symptoms such as upper abdominal pain, indigestion, loss of appetite, and early satiety may appear. As the disease progresses, complications or metastases can lead to more severe symptoms like difficulty swallowing, nausea, vomiting, black stools, and persistent abdominal pain.
For diagnosis, X-ray barium meal examination has a high success rate, reaching up to 90% for advanced cases. However, the most reliable method today is gastroscopy combined with mucosal biopsy, which has a diagnostic accuracy of around 95%. Patients with risk factors should undergo regular screening. Surgery remains the only potentially curative treatment for gastric cancer, and the success rate and 5-year survival depend largely on the stage at which the cancer is detected, as well as how far it has spread. Chemotherapy is frequently used alongside surgery to improve outcomes.
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