Stomach cancer is a malignant tumor that originates from the epithelium of the gastric mucosa. Worldwide, it ranks fifth in incidence among oncological diseases and third in mortality. Early manifestations are nonspecific, so the diagnosis is often made late.
What is stomach cancer
The tumor can develop in any part of the stomach and spread to other organs—especially the esophagus, lungs, and liver.
Stomach cancer accounts for about 7% of cancer cases worldwide and 9% of cancer deaths; it is more common in men. Two-thirds of those affected are people over 65 years of age.
Causes and risk factors for stomach cancer
The most consistent risk factor is Helicobacter pylori infection: in infected individuals, the risk is approximately 2.5 times higher, and in 1994 the WHO International Agency for Research on Cancer classified it as a group 1 carcinogen.
Most cases are preceded by a long precancerous process: chronic gastritis—multifocal atrophy—intestinal metaplasia—intraepithelial neoplasia; this process progresses to adenocarcinoma. Cardial (proximal) stomach cancer is not associated with this infection.
The following increase the risk:
- Helicobacter pylori infection and chronic inflammation of the mucosa;
- male sex;
- excess salt, smoked and marinated products, alcohol;
- smoking;
- family history of stomach cancer.
Atrophic gastritis, adenomatous polyps, and pernicious anemia are also mentioned separately, as well as an increased risk 5–10 years after gastric surgery that promotes reflux.
First signs of stomach cancer
In the early stages, manifestations are nonspecific: dyspepsia, decreased appetite, discomfort in the stomach. In one out of fifty patients presenting with complaints of dyspepsia, stomach cancer is detected.
The small-sign syndrome—asthenia, aversion to meat, anemia, weight loss—is more common in advanced forms.
Early satiety and a feeling of fullness after a small amount of food are characteristic of endophytic growth, when the stomach becomes rigid; dysphagia is typical for cardial cancer, and impaired evacuation with vomiting for pyloric cancer.
In late stages, epigastric pain, vomiting, and bleeding due to ulceration of the tumor are added: black tarry stools, vomiting of “coffee grounds” or blood.
Gastritis and stomach cancer: is there a link
An increased risk of stomach cancer is associated with chronic gastritis, atrophic gastritis, and H. pylori infection.
In H. pylori-infected individuals, the risk of stomach cancer is significantly increased—relative ratio 2.5. The bacterium causes histological changes: atrophy of the mucous membrane, intestinal metaplasia, and epithelial dysplasia; atrophic gastritis is considered a predisposing factor.
Eradication of H. pylori may prevent the development of stomach cancer, but after intestinal metaplasia has formed, it no longer prevents cancer development, although it can slow its progression.
The diagnosis is established by a physician based on the results of endoscopy and biopsy.
How it is diagnosed: upper GI endoscopy and blood tests
The diagnosis is made based on a combination of data: examination, blood tests, and imaging studies, endoscopy and biopsy; upper GI endoscopy is the Russian equivalent of endoscopy of the upper gastrointestinal tract.
Anemia is indicated as a possible sign in advanced forms of the disease. Blood tests are part of the examination set, but their results are evaluated together with other studies.
Stages of stomach cancer and when to see a doctor
The stage number is determined by the physician based on examination results. Metastases occur in 80–90% of patients with stomach cancer.
Six-month survival is about 65% with early diagnosis and less than 15% in late stages.
Dyspepsia and discomfort in the stomach may be symptoms of early cancer, but the same symptoms are caused by other diseases. If there is blood in the stool, vomiting, unexplained weight loss, jaundice, or difficulty swallowing, you should see a doctor.
Stomach cancer itself is not a reason to call an ambulance. 103 or 112—if vomiting of blood or “coffee grounds” appears, black tarry stools, or other signs of severe gastrointestinal bleeding.
The material is for reference: it does not replace a doctor's consultation and describes only general patterns.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer