Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Abstract

Although the incidence of gastric cancer is decreasing, there were still 159 900 new cases in Europe in 2006, and ∼118 200 deaths, representing the fifth highest incidence and fourth highest cause of cancer-related death. The overall incidence of gastric cancers is declining; however, there has been a relative increase in the incidence of tumours of the oesophago-gastric junction (OGJ) and gastric cardia. The peak incidence is in the seventh decade, and the disease is approximately twice as common in men as women. There is marked geographic variation, with the highest rates in East Asia, South America and Eastern Europe and the lowest rates in the United States and Western Europe. Risks include male gender, cigarette smoking, Helicobacter pylori infection, atrophic gastritis, partial gastrectomy, Menetrier's disease and genetic factors such as hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, hereditary diffuse gastric cancer and Peutz–Jeghers syndrome. Obesity may also be a risk factor for tumours of the OGJ/cardia.