From the Guidelines
The lifetime incidence of gastric cancer in the United States is approximately 0.6% for men, as stated in the most recent and highest quality study 1. This means that about 1 in 167 men will develop gastric cancer during their lifetime. The incidence of gastric cancer in the US has been declining over the past several decades, largely due to improvements in food preservation, decreased prevalence of Helicobacter pylori infection, and changes in dietary habits. Some key points to consider include:
- Risk factors that increase one's likelihood of developing gastric cancer include chronic H. pylori infection, smoking, high salt intake, family history, and certain genetic conditions.
- Regular screening is not recommended for the general US population due to the relatively low incidence, but individuals with high-risk factors may benefit from periodic endoscopic surveillance.
- The natural history of gastric cancer risk is an exponential increase with age, and eradication of H. pylori infection can halt the increase of risk and reduce the overall risk of gastric cancer 1.
- The approach to gastric cancer prevention depends on the prevalence of gastric cancer in general, as well as within specific subpopulations with proven high risk of gastric cancer, and may involve testing for H. pylori infection and eradication treatment in high-risk groups 1. It's also worth noting that the incidence of gastric cancer varies geographically, with higher rates in East Asia, and that the global incidence of gastric cancer shows wide geographic variation, with a 15- to 20-fold difference between high- and low-incidence regions 1.
From the Research
Gastric Cancer Incidence in the United States
- The incidence of gastric cancer in the United States has decreased over the past five decades 2.
- However, rates of noncardia gastric cancer among adults aged less than 50 years in the United States are increasing 2.
- Gastric cancer incidence in the USA shows significant racial and ethnic disparities, with gastric cancer incidence in Korean Americans being over five times higher than in non-Hispanic whites 3.
- The burden of gastric cancer is significantly higher in males compared to females, with the highest incidence and prevalence in females in the age group of 75-79 years, and in males in the age group of 70-74 years 4.
Lifetime Incidence of Gastric Cancer
- Approximately 5.0% of gastric cancer patients are diagnosed before the age of 40 5.
- The incidence of gastric cancer in young adults has declined over time in most countries except in the United States 5.
- There is no specific data available on the lifetime incidence of gastric cancer in the United States, but the age-standardized incidence rates (ASIR) have trended downward from 1990 to 2021 4.
Risk Factors and Prevention
- The main risk factors for gastric cancer include increasing age, male sex, non-White race, Helicobacter pylori infection, and smoking 2.
- Strengthening preventive interventions, particularly for men and patients over the age of 60, will be crucial in reducing the burden of gastric cancer in the United States 4.
- Early detection of gastric cancer is the principal strategy to reduce gastric cancer mortality and improve survival, and initiating gastric cancer screening guidelines for high-risk groups can have the potential to improve survival by diagnosing and treating gastric cancer at an earlier stage 6, 3.