THE RISK FACTORS FOR STOMACH CANCER
Scientists have found several risk factors that make a person more likely to get stomach cancer. Some of these can be controlled, but others cannot. These are some of the risk factors:
Gender: Stomach cancer is more common in men than in women.
Age: There is a sharp increase in stomach cancer rates in people over the age of 50. Most people diagnosed with stomach cancer are between their late 60s and 80s. However, the disease tends to be detected in young people increasingly and often has a bad prognosis.
Ethnicity: In the United States, stomach cancer is more common in Hispanic Americans, African Americans, and Asian/Pacific Islanders than in non-Hispanic whites.
Geography: Worldwide, stomach cancer is more common in Japan, China, Southern and Eastern Europe, and South and Central America. This disease is less common than in Northern and Western Africa, South Central Asia, and North America.
Helicobacter pylori infection: Infection with Helicobacter pylori (H pylori) bacteria seems to be a major cause of stomach cancer, especially cancers in the lower (distal) part of the stomach. Even so, most people who carry this germ in their stomach never develop cancer.
Stomach lymphoma: Patients with mucosa-associated lymphoid tissue (MALT) lymphoma have an increased risk of getting adenocarcinoma of the stomach. This is probably because MALT lymphoma of the stomach is caused by infection with H pylori bacteria.
Diet: An increased risk of stomach cancer is seen in people with diets that have large amounts of smoked foods, salted fish and meat, and pickled vegetables.
Tobacco use and drinking alcohol: Smoking and drinking alcohol increases stomach cancer risk, particularly for cancers of the upper portion of the stomach near the esophagus. The rate of stomach cancer is about doubled in smokers.
Being overweight or obese: Being overweight or obese is a possible cause of cancers of the cardia (the upper part of the stomach nearest the esophagus).
Previous stomach surgery: Stomach cancers are more likely to develop in people who have had part of their stomach removed to treat non-cancerous diseases, such as ulcers. These cancers typically develop many years after the surgery.
Pernicious anemia: People with anemia (too few red blood cells) have an increased risk of stomach cancer.
Menetrier disease (hypertrophic gastropathy): Because this disease is very rare, it is not known exactly how much this increases the risk of stomach cancer.
Type A blood: For unknown reasons, people with type A blood have a higher risk of getting stomach cancer.
Inherited cancer syndromes: Some inherited conditions may raise a person's risk of stomach cancer.
• Familial adenomatous polyposis (FAP). This syndrome causes polyps in the colon, stomach, and intestines, often caused by gene APC mutations. This syndrome greatly increases a person's risk of colorectal cancer and may play a small role in increasing a person's stomach cancer risk.
• BRCA1 and BRCA2. Inherited mutations on the BRCA1 and BRCA2 genes are often associated with higher risks for breast cancer. Individuals who have inherited these genetic mutations are also at an increased risk for stomach cancer.
• Lynch syndrome. This condition may also be referred to as hereditary non-polyposis colorectal cancer (HNPCC), a genetic condition that runs in families. More commonly, this condition is associated with an increased risk for colon cancer. HNPCC also predisposes people to stomach cancers.
• E-cadherin/CDH1. Hereditary diffuse gastric cancer. Though rare, people who inherit this genetic mutation have a 70 to 80 percent chance of developing stomach cancer in their lifetime. Also, women with this genetic defect have an increased risk of breast cancer.
• Li-Fraumeni syndrome. People with this syndrome have an increased risk of several types of cancer, including developing stomach cancer at a relatively young age. A mutation in the TP53 gene causes Li-Fraumeni syndrome.
• Peutz-Jeghers syndrome (PJS). People with this condition develop polyps in the stomach and intestines, as well as in other areas, including the nose, the airways of the lungs, and the bladder. The polyps in the stomach and intestines are a special type called hamartomas. They can cause problems like bleeding or blockage of the intestines. PJS can also cause dark freckle-like spots on the lips, inner cheeks, and other areas. People with PJS have an increased risk of cancers of the breast, colon, pancreas, stomach, and several other organs. Mutations cause this syndrome in the gene STK1.
A family history of stomach cancer: People with first-degree relatives (parents, siblings, or children) who have had stomach cancer are more likely to develop this disease.
Some types of stomach polyps: Polyps are non-cancerous growths on the lining of the stomach. Most types of polyps (such as hyperplastic polyps or inflammatory polyps) do not seem to increase a person's risk of stomach cancer. However, adenomatous polyps – also called adenomas – can sometimes develop into cancer.
Epstein-Barr virus (EBV) infection: The Epstein-Barr virus causes infectious mononucleosis (also called mono). Almost all adults have been infected with this virus at some time in their lives, usually as children or teens.
EBV has been linked to some forms of lymphoma. It is also found in the cancer cells of about 5% to 10% of people with stomach cancer. These people tend to have a slower growing, less aggressive cancer with a lower tendency to spread. In some stomach cancer cells, EBV has been found, but it is not yet clear if this virus actually causes stomach cancer.
Particular occupations: Workers in the coal, metal, and rubber industries seem to have a higher risk of stomach cancer.
Common variable immune deficiency (CVID): People with CVID have an increased risk of stomach cancer. The immune system of someone with CVID can not make enough antibodies in response to germs. People with CVID have frequent infections as well as other problems, including atrophic gastritis and pernicious anemia. They are also more likely to get gastric lymphoma and stomach cancer.
Jan 21, 2021
HUNG M. DO, MD, Ph.D
