Friday, November 20, 2009

How can I prevent gastric cancer

There is no one risk factor directly associated with gastric cancer, there is no strict lifestyle change that can greatly decrease a person's risk of developing gastric cancer. However, eating a "Western" type diet, without heavily smoked or salted foods and rich in fruits and vegetables will likely decrease a person's risk. Also, smoking cessation will likely decrease gastric cancer risk (though smoking should be stopped for numerous other health reasons). Some have advocated the consumption of foods with high level of antioxidants and vitamin C to prevent gastric cancers, though this has not been definitively proven. Since H. pylori infections have been linked to the development of gastric cancers, the quick treatment of H. pylori infections may decrease the numbers of gastric cancers, though whether treating H. Pylori actually reduces the risk ofgastic cancer remains controversial. The decision to treat H. pylori should be discussed with your physician.

What screening tests are available

There are no established programs for primary prevention of gastric cancer in the United States. There are no plans to initiate a screening program in the United States, simply because the incidence of gastric cancer is fairly low, and thus the yield from gastric cancer screening would be far too low to approach cost-effectiveness. A few populations may be exceptions (e.g.-patients with known atrophic gastritis), but overall screening for gastric cancer in the United States would likely cause more problems than it would solve (i.e. a lot of false positives, or false alarms). Currently, screening for H. Pylori is not recommended for areas with a relatively low incidence of gastric cancer, such as in the United States.

In some Japanese centers, where gastric cancer is much more prevalent, screening has been more successful. A variety of tests have been used in these screening programs, with the ability to accurately identify gastric cancers in over 90% of patients who actually have it. These tests include double-contrast barium radiographs (so-call "upper GIs" or "barium swallows") and upper endoscopies. An upper endoscopy (or an "EGD") is a test done using a camera at the end of a long tube that is placed down the patient's throat to the stomach itself. The physician performing the EGD is able to directly visualize the stomach. Many abnormalities can be detected with an EGD-most importantly, ulcers and cancers. Patients are sedated during the procedure, so discomfort is kept to a minimum.

More recently, studies have verified the use of a newer blood test that could be used for screening for gastric cancer. This analyzes the presence of enzymes in the blood called the serum pepsinogen I/II ratio, which is low in patients at risk for atrophic gastritis and gastric cancer. However, this is still in the earlier stage of testing and needs to be verified.

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