Gastric Malignancy was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.
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- May occur anywhere in the stomach
- Infiltration to lymph nodes, omentum, lungs, and liver is rapid.
- Uncommon in US natives
- Synonym(s): Linitis plastica
- Rarely diagnosed during pregnancy
- Prognosis is poor if diagnosed.
- Predominant age: >55 (2/3 >65)
- Predominant gender: Male > Female (1.7:1)
- Incidence is decreasing globally, but it remains the 2nd-leading cause of cancer death.
- 5.9/100,000 males (North America)
- 2.5/100,000 females (North America)
- 21,130 new cases per year (US)
- Helicobacter pylori infection
- Atrophic gastritis/intestinal metaplasia
- Pernicious anemia
- Prior gastric resection
- Polyps or dysplasia anywhere in alimentary canal
- Familial polyposis
- Barrett esophagus
- Smoking/Tobacco abuse
- Patients in lower socioeconomic classes are at greater risk of developing gastric tumors.
- Diet rich in additives (e.g., smoked, pickled, or salted foods; highly spiced Asian foods)
- Low consumption of fruits and vegetables
- Overweight and obesity: Strength of association increases with increasing body mass index (BMI)
- Ethnic background: Hispanic, Japanese, Chilean, Costa Rican:
- Migrants from high-incidence areas (e.g., Iceland, Chile, or Japan) to low-incidence areas maintain an increased risk, whereas their offspring have an occurrence rate that corresponds to that of the new location.
- More common in people with blood group A
- 2–4 times more common in 1st-degree relatives
- 1–3% of gastric cancers are associated with inherited gastric cancer predisposition syndromes, known as hereditary diffuse gastric cancer.
- Amplification or overexpression of the HER2 protein is associated with some gastric cancers:
- May play a role in pathogenesis and progression
- A healthy lifestyle (not smoking, not consuming excess alcohol, avoiding obesity, and maintaining a good diet) is associated with reduced risk of gastric cancer:
- Diets including 5–20 servings of both fruits and vegetables each week reduce the risk of gastric malignancy by ~50%.
- Insufficient data to establish that screening would decrease mortality in US population
- Screening may be of benefit in high-prevalence areas.
Commonly Associated Conditions
- Giant hypertrophic gastritis (Ménétrier disease)
- Intestinal metaplasia of the stomach
- Atrophic gastritis
- H. pylori infection