Gastric cancer is the cancer originating in the esophagus, esophagogastric junction and stomach.
Most of gastric cancers are adenocarcinomas, subdivided according to histological appearances into diffuse (undifferentiated) and intestinal (well differentiated) types.
It is the 4th most common cancer and the 2nd most common cause of cancer-related deaths worldwide.
Most common sites of gastric cancer are the proximal lesser curvature, cardia and esophagogastric junction.


  • Fourth most common cancer & second most common cause of cancer-related deaths worldwide
    • In Japan, this is the most common type of cancer in men
  • Most common sites of gastric cancer are the proximal lesser curvature, cardia & esophagogastric junction


  • Cancers originating in the esophagus, esophagogastric junction & stomach
  • Most of gastric cancers (90%) are adenocarcinomas, subdivided according to histological appearances into diffuse (undifferentiated) & intestinal (well-differentiated) types (Lauren classification)

Signs and Symptoms

  • Early stage gastric cancer rarely causes symptoms
    • Most commonly diagnosed at an advanced stage
  • Dyspepsia is the early stage symptom
  • Advanced stage signs & symptoms include:
    • Poor appetite
    • Weight loss
    • Dysphagia
    • Abdominal pain
    • Vague abdominal discomfort, usually above the navel
    • A sense of fullness in the upper abdomen after eating a small meal (early satiety)
    • Heartburn or indigestion
    • Nausea & vomiting
    • Swelling or fluid build-up in the abdomen
    • Iron-deficiency anemia

Risk Factors

  • Male
  • Old age (>50 years old)
  • Helicobacter pylori infection
    • Usually the major cause
  • Cigarette/tobacco use
  • Previous gastric surgery eg partial gastrectomy
  • Menetrier’s disease or hypertrophic gastropathy
  • Atrophic gastritis
  • Diet that has large amounts of smoked foods, salted fish & meat & pickled vegetables
    • Nitrates & nitrites on these foods have shown to produce bacteria that causes cancer
  • Stomach lymphoma
  • Pernicious anemia
  • Type A blood
  • Overweight or obesity
  • Inherited cancer syndromes (3-5%) eg hereditary diffuse gastric cancer, hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, breast cancer, Li-Fraumeni syndrome, Peutz-Jeghers syndrome
  • Family history of stomach cancer (5-10%)
  • Epstein-Barr virus
  • Certain occupations eg coal, metal & rubber industry workers
  • Common variable immune deficiency
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