See chapter 7.5 page 265 in WCRF/AICR Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective.
Worldwide common cancer. One million new stomach cancer cases in 2002, 2/3 occur in developing countries.
Incidence and death is in general rapidly decreasing in developed world, but remains high elsewhere.
Distinct geographical pattern: highest rates in Japan, Eastern Asia, Central (and South America).
Incidence rates about twice as high in men as in women.
Migrants from high- to low- risk countries tend to maintain the high-risk in that generation – next generation lower risk.
Poor survival, 5-year survival is 20%.
One of two major cancers agreed to be predominantly modified by food and nutrition.
Why is stomach cancer decreasing in high-income countries, but still high elsewhere?
- Non-dietary factors: Helicobacter pylori infection World Journal of Gastroenterology
- (However, infection alone is not sufficient, as 40-60% of people in populations at low risk of stomach cancer are infected)
- Natural history:
Normal mucosa → superficial gastritis → Chronic atrophic gastritis → intestinal metaplasia → dysplasia → carcinoma.
- H pylori infection and excessive salt intake are involved in the etiology of superficial and chronic atrophic gastritis.
- Role of carotenoids and role of formation of N-Nitroso compounds?
CONVINCING EVIDENCE - decreases risk:
CONVINCING EVIDENCE - increases risk:
PROBABLE EVIDENCE - decreases risk:
- Vegetables, allium vegetables, fruits
PROBABLE EVIDENCE - increases risk:
- Salted and salty foods
LIMITED/SUGGESTIVE EVIDENCE - decreases risk:
Foods containing selenium
LIMITED/SUGGESTIVE EVIDENCE - increases risk:
Grilled or barbecued animal food
Most effective means of preventing:
- Diets high in fruits and vegetables