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STOMACH CANCER

http://meddev.uio.no/elaring/lcms13/ernaeringslaere/nutr-cancer-epidemiology/illustrations/stomach.jpg

See chapter 7.5 page 265 in WCRF/AICR Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective.

pdf Cancers


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.

Discussion question:
Why is stomach cancer decreasing in high-income countries, but still high elsewhere?

http://meddev.uio.no/elaring/lcms13/ernaeringslaere/nutr-cancer-epidemiology/illustrations/incidence_2008_stomach.jpg

Pathogenesis:

  • (However, infection alone is not sufficient, as 40-60% of people in populations at low risk of stomach cancer are infected)
  • Smoking
  • 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:

  • None

CONVINCING EVIDENCE - increases risk:

  • None


PROBABLE EVIDENCE - decreases risk:

  • Vegetables, allium vegetables, fruits

PROBABLE EVIDENCE - increases risk:

  • Salt
  • Salted and salty foods


LIMITED/SUGGESTIVE EVIDENCE - decreases risk:
Pulses
Foods containing selenium

LIMITED/SUGGESTIVE EVIDENCE - increases risk:
Chilli
Processed meat
Grilled or barbecued animal food

Most effective means of preventing:

  • Diets high in fruits and vegetables