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Current Gastroenterology Reports
Published in: Current Gastroenterology Reports 7/2016

Open Access 01-07-2016 | GI Oncology (R Bresalier, Section Editor)

Gastric Cancer: How Can We Reduce the Incidence of this Disease?

Authors: Caroline M. den Hoed, Ernst J. Kuipers

Published in: Current Gastroenterology Reports | Issue 7/2016

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Abstract

Gastric cancer remains a prevalent disease worldwide with a poor prognosis. Helicobacter pylori plays a major role in gastric carcinogenesis. H. pylori colonization leads to chronic gastritis, which predisposes to atrophic gastritis, intestinal metaplasia, dysplasia, and eventually gastric cancer. Screening, treatment, and prevention of H. pylori colonization can reduce the incidence of gastric cancer. Other interventions that may yield a similar effect, although of smaller magnitude, include promotion of a healthy lifestyle including dietary measures, non-smoking, low alcohol intake, and sufficient physical activity. This chapter reviews interventions that can lead to a decline in gastric cancer incidence in high and low incidence countries.
Literature
1.
Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.CrossRefPubMed
2.
Ferlay J, SI, Ervik M, Dikshit R, et al. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC CancerBase No. 11. 2012 [cited 2016 January 25]; Available from: http://​globocan.​iarc.​fr.
3.
Arnold M, Moore SP, Hassler S, et al. The burden of stomach cancer in indigenous populations: a systematic review and global assessment. Gut. 2014;63(1):64–71.CrossRefPubMed
4.
Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet. 1975;2(7924):58–60.CrossRefPubMed
5.
Naghavi M, Whang H, Lozano R et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117–71.
6.
7.
Song H, Held M, Sandin S, et al. Increase in the prevalence of atrophic gastritis among adults age 35 to 44 years old in Northern Sweden between 1990 and 2009. Clin Gastroenterol Hepatol. 2015;13(9):1592–600 e1.CrossRefPubMed
8.
You WC, Brown LM, Zhang L, et al. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst. 2006;98(14):974–83.CrossRefPubMed
9.•
Ma JL, Zhang L, Brown LM, et al. Fifteen-year effects of Helicobacter pylori, garlic, and vitamin treatments on gastric cancer incidence and mortality. J Natl Cancer Inst. 2012;104(6):488–92. The authors demonstrate, in this well designed population based study with long follow up, that gastric cancer incidence is reduced by H. pylori eradication and vitamin intake, but not by garlic intake.CrossRefPubMedPubMedCentral
10.
Wong BC, Lam SK, Wong WM, et al. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA. 2004;291(2):187–94.CrossRefPubMed
11.•
Lee YC, Chen TH, Chiu HM, et al. The benefit of mass eradication of Helicobacter pylori infection: a community-based study of gastric cancer prevention. Gut. 2013;62(5):676–82. The authors demonstrate in this community based study that the mass eradication of H. pylori is a succesfull intervention in the reduction of gastric cancer incidence. The intervention was effective for reducing the incidence of atrophic gastritis, but not for reducing the incidence of intestinal metaplasia.CrossRefPubMed
12.
Take S, Mizuno M, Ishiki K, et al. The effect of eradicating helicobacter pylori on the development of gastric cancer in patients with peptic ulcer disease. Am J Gastroenterol. 2005;100(5):1037–42.CrossRefPubMed
13.
Ogura K, Hirata Y, Yanai A, et al. The effect of Helicobacter pylori eradication on reducing the incidence of gastric cancer. J Clin Gastroenterol. 2008;42(3):279–83.PubMed
14.•
Ford AC, Forman D, Hunt R, et al. Helicobacter pylori eradication for the prevention of gastric neoplasia. Cochrane Database Syst Rev. 2015;7:CD005583. This Cochrane meta analysis concludes that there is limited, moderate-quality evidence that searching for and eradicating H. pylori reduces the incidence of gastric cancer in healthy asymptomatic infected Asian individuals, the data cannot necessarily be extrapolated to other populations.PubMed
15.
16.
Li WQ, Ma JL, Zhang L, et al. Effects of Helicobacter pylori treatment on gastric cancer incidence and mortality in subgroups. J Natl Cancer Inst. 2014;106(7).
17.
Fukase K, Kato M, Kikuchi S, et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial. Lancet. 2008;372(9636):392–7.CrossRefPubMed
18.
Nakagawa S, Asaka M, Kato M, et al. Helicobacter pylori eradication and metachronous gastric cancer after endoscopic mucosal resection of early gastric cancer. Aliment Pharmacol Ther. 2006;24:214–8.CrossRef
19.
Uemura N, Mukai T, Okamoto S, et al. Effect of Helicobacter pylori eradication on subsequent development of cancer after endoscopic resection of early gastric cancer. Cancer Epidemiol Biomarkers Prev. 1997;6(8):639–42.PubMed
20.•
Maehata Y, Nakamura S, Fujisawa K, et al. Long-term effect of Helicobacter pylori eradication on the development of metachronous gastric cancer after endoscopic resection of early gastric cancer. Gastrointest Endosc. 2012;75(1):39–46. In this single center retrospective study the authors studied the effect of H. pylori eradication after the endoscopic resection of early gastric cancer. They do not demonstrate a positive effect of eradication on the development of metachronous gastric cancer.CrossRefPubMed
21.•
Bae SE, Jung HY, Kang J, et al. Effect of Helicobacter pylori eradication on metachronous recurrence after endoscopic resection of gastric neoplasm. Am J Gastroenterol. 2014;109(1):60–7. The authors demonstrate with this large retrospective study that there is a positive effect of H. pylori eradication on the occurrence of metachronous gastric cancer after endoscopic resection of early gastric cancer. This positive effect was seen in patient with and without precancerous lesions.
22.
Shin SH, da Jung H, Kim JH, et al. Helicobacter pylori eradication prevents metachronous gastric neoplasms after endoscopic resection of gastric dysplasia. PLoS One. 2015;10(11), e0143257.CrossRefPubMedPubMedCentral
23.•
Lansdorp-Vogelaar I, Sharp L. Cost-effectiveness of screening and treating Helicobacter pylori for gastric cancer prevention. Best Pract Res Clin Gastroenterol. 2013;27(6):933–47. Study on the cost-effectiveness of H. pylori eradication on gastric cancer incidence in high- and low-incidence countries.
24.
Hildebrand P, Bardhan P, Rossi L, et al. Recrudescence and reinfection with Helicobacter pylori after eradication therapy in Bangladeshi adults. Gastroenterology. 2001;121(4):792–8.CrossRefPubMed
25.
Czinn SJ, Blanchard T. Vaccinating against Helicobacter pylori infection. Nat Rev Gastroenterol Hepatol. 2011;8(3):133–40.CrossRefPubMed
26.•
Sugano K, Tack J, Kuipers EJ, et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015;64(9):1353–67. Recent consensus report on the endoscopic diagnosis, screening and follow up of premalignant gastric lesions.CrossRefPubMedPubMedCentral
27.
Tahara T, Shibata T, Nakamura M, et al. Gastric mucosal pattern by using magnifying narrow-band imaging endoscopy clearly distinguishes histological and serological severity of chronic gastritis. Gastrointest Endosc. 2009;70(2):246–53.CrossRefPubMed
28.
Capelle LG, de Vries AC, Haringsma J, et al. The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc. 2010;71(7):1150–8.CrossRefPubMed
29.•
Dinis-Ribeiro M, Areia M, de Vries AC, et al. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Virchows Arch. 2012;460(1):19–46. European guideline on the surveillance of precancerous gastric lesions.CrossRefPubMed
30.
Rugge M, Meggio A, Pennelli G, et al. Gastritis staging in clinical practice: the OLGA staging system. Gut. 2007;56(5):631–6.CrossRefPubMed
31.•
Huang YK, Yu JC, Kang WM, et al. Significance of serum pepsinogens as a biomarker for gastric cancer and atrophic gastritis screening: a systematic review and meta-analysis. PLoS One. 2015;10(11):e0142080. The authors of this meta-analysis conclude that there is great potential in the use of serum pepsinogens as serologic screening. Because of considerable heterogeneity in the studies and possible publication bias, no clear conclusions are drawn on the practical use of pepsinogens as general screening method. CrossRefPubMedPubMedCentral
32.
Ichinose M. Screening for gastric cancer in Japan. In: Wu GY, Aziz K. Cancer screening for common malignancies. Totawa: Humana Press; 2001. p. 87–102.
33.•
Hamashima C, Ogoshi K, Narisawa R, et al. Impact of endoscopic screening on mortality reduction from gastric cancer. World J Gastroenterol. 2015;21(8):2460–6. The authors demonstrate a risk reduction of 57 % in gastric cancer by performing population based endoscopic screening. The participation rate in the study was low with only 25 %. CrossRefPubMedPubMedCentral
34.
Hamashima C, Ogoshi K, Okamoto M, et al. A community-based, case–control study evaluating mortality reduction from gastric cancer by endoscopic screening in Japan. PLoS One. 2013;8(11), e79088.CrossRefPubMedPubMedCentral
35.
Ohata H, Kitauchi S, Yoshimura N, et al. Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer. Int J Cancer. 2004;109(1):138–43.CrossRefPubMed
36.
Yanaoka K, Oka M, Yoshimura N, et al. Risk of gastric cancer in asymptomatic, middle-aged Japanese subjects based on serum pepsinogen and Helicobacter pylori antibody levels. Int J Cancer. 2008;123(4):917–26.CrossRefPubMed
37.•
Yoshida T, Kato J, Inoue I, et al. Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer. Int J Cancer. 2014;134(6):1445–57. Study on the relationship between gastric cancer development and H. pylori status and serum pepsinogens. The study performed in asymptomatic subjects demonstrates that serum levels of pepsinogens and H. pylori antibody titer provide indices of the risk of gastric cancer development.CrossRefPubMed
38.
Kurilovich S, Belkovets A, Reshetnikov O, et al. Stomach-specific biomarkers (GastroPanel) can predict the development of gastric cancer in a Caucasian population: a longitudinal nested case–control study in Siberia. Anticancer Res. 2016;36(1):247–53.PubMed
39.
Dinis-Ribeiro M, Yamaki G, Miki K, et al. Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening. J Med Screen. 2004;11(3):141–7.CrossRefPubMed
40.
Yeh JM, Hur C, Ward Z, et al. Gastric adenocarcinoma screening and prevention in the era of new biomarker and endoscopic technologies: a cost-effectiveness analysis. Gut. 2015.
41.
Areia M, Dinis-Ribeiro M, Rocha Goncalves F. Cost-utility analysis of endoscopic surveillance of patients with gastric premalignant conditions. Helicobacter. 2014;19(6):425–36.CrossRefPubMed
42.•
Nam JH, Choi IJ, Cho SJ, et al. Association of the interval between endoscopies with gastric cancer stage at diagnosis in a region of high prevalence. Cancer. 2012;118(20):4953–60. The authors demonstrate that a significant benefit in gastric cancer stage at diagnosis was observed in all screened subjects compared to the never screened subjects. Endoscopy intervals of 3 years or less show similar benefits, while intervals of 4 or 5 years lead to the diagnosis of more advanced stage gastric cancer.CrossRefPubMed
43.
Whiting JL, Sigurdsson A, Rowlands DC, et al. The long term results of endoscopic surveillance of premalignant gastric lesions. Gut. 2002;50(3):378–81.CrossRefPubMedPubMedCentral
44.
Riboli E, Hunt KJ, Slimani N, et al. European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collection. Public Health Nutr. 2002;5(6B):1113–24.CrossRefPubMed
45.•
Buckland G, Travier N, Huerta JM, et al. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study. Int J Cancer. 2015;137(3):598–606. Data from the EPIC cohort study—a large prospective study conducted in 10 European countries on diet, lifestyle, metabolic, and environmental factors on chronic diseases such as gastric cancer.CrossRefPubMed
46.
Shikata K, Kiyohara Y, Kubo M, et al. A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population: the Hisayama study. Int J Cancer. 2006;119(1):196–201.CrossRefPubMed
47.
Joossens JV, Hill MJ, Elliott P, et al. Dietary salt, nitrate and stomach cancer mortality in 24 countries. European Cancer Prevention (ECP) and the INTERSALT Cooperative Research Group. Int J Epidemiol. 1996;25(3):494–504.CrossRefPubMed
48.•
Gonzalez CA, Lujan-Barroso L, Bueno-de-Mesquita HB, et al. Fruit and vegetable intake and the risk of gastric adenocarcinoma: a reanalysis of the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study after a longer follow-up. Int J Cancer. 2012;131(12):2910–9. Data from the EPIC cohort study—a large prospective study conducted in 10 European countries on diet, lifestyle, metabolic, and environmental factors on chronic diseases such as gastric cancer.CrossRefPubMed
49.•
Jeurnink SM, Buchner FL, Bueno-de-Mesquita HB, et al. Variety in vegetable and fruit consumption and the risk of gastric and esophageal cancer in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer. 2012;131(6):E963-73. Data from the EPIC cohort study—a large prospective study conducted in 10 European countries on diet, lifestyle, metabolic, and environmental factors on chronic diseases such as gastric cancer.CrossRefPubMed
50.
Moller ME, Dahl R, Bockman OC. A possible role of the dietary fibre product, wheat bran, as a nitrite scavenger. Food Chem Toxicol. 1988;26(10):841–5.CrossRefPubMed
51.
Zhang Z, Xu G, Ma M, et al. Dietary fiber intake reduces risk for gastric cancer: a meta-analysis. Gastroenterology. 2013;145(1):113–120 e3.CrossRefPubMed
52.
Kong P, Cai Q, Geng Q, et al. Vitamin intake reduce the risk of gastric cancer: meta-analysis and systematic review of randomized and observational studies. PLoS One. 2014;9(12), e116060.CrossRefPubMedPubMedCentral
53.
Kodali RT, Eslick GD. Meta-analysis: does garlic intake reduce risk of gastric cancer? Nutr Cancer. 2015;67(1):1–11.CrossRefPubMed
54.
Xiao Q, Freedman ND, Ren J, et al. Intakes of folate, methionine, vitamin B6, and vitamin B12 with risk of esophageal and gastric cancer in a large cohort study. Br J Cancer. 2014;110(5):1328–33.CrossRefPubMedPubMedCentral
55.
Inoue M, Sasazuki S, Wakai K, et al. Green tea consumption and gastric cancer in Japanese: a pooled analysis of six cohort studies. Gut. 2009;58(10):1323–32.CrossRefPubMed
56.
Boehm K, Borrelli F, Ernst E, et al. Green tea (Camellia sinensis) for the prevention of cancer. Cochrane Database Syst Rev. 2009;3, CD005004.PubMed
57.
58.
Tramacere I, Negri E, Pelucchi C, et al. A meta-analysis on alcohol drinking and gastric cancer risk. Ann Oncol. 2012;23(1):28–36.CrossRefPubMed
59.
Pan KF, Zhang L, Gerhard M, et al. A large randomised controlled intervention trial to prevent gastric cancer by eradication of Helicobacter pylori in Linqu County, China: baseline results and factors affecting the eradication. Gut. 2016;65(1):9–18.CrossRefPubMed
60.
Steffen A, Huerta JM, Weiderpass E, et al. General and abdominal obesity and risk of esophageal and gastric adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition. Int J Cancer. 2015;137(3):646–57.CrossRefPubMed
61.
Chen Y, Liu L, Wang X, et al. Body mass index and risk of gastric cancer: a meta-analysis of a population with more than ten million from 24 prospective studies. Cancer Epidemiol Biomarkers Prev. 2013;22(8):1395–408.CrossRefPubMed
62.•
Singh PP, Singh S. Statins are associated with reduced risk of gastric cancer: a systematic review and meta-analysis. Ann Oncol. 2013;24(7):1721–30. The authors performed a meta-analysis on the effect of Statins on gastric cancer risk. The study demonstrates a reduction in gastric cancer risk with the use of statins. The number needed to treat to prevent one gastric cancer case is high. CrossRefPubMed
63.
Wu XD, Zeng K, Xue FQ, et al. Statins are associated with reduced risk of gastric cancer: a meta-analysis. Eur J Clin Pharmacol. 2013;69(10):1855–60.CrossRefPubMed
64.
Saukkonen K, Rintahaka J, Sivula A, et al. Cyclooxygenase-2 and gastric carcinogenesis. APMIS. 2003;111(10):915–25.CrossRefPubMed
65.
Yang P, Zhou Y, Chen B, et al. Aspirin use and the risk of gastric cancer: a meta-analysis. Dig Dis Sci. 2010;55(6):1533–9.CrossRefPubMed
66.•
Kim YI, Kim SY, Kim JH, et al. Long-term Low-dose aspirin use reduces gastric cancer incidence: a Nationwide Cohort Study. Cancer Res Treat. 2015. In this retrospective-matched case–control study, the authors conclude that the use of Aspirin 100 mg once a day results in a reduced gastric cancer risk, particularly in subjects using Aspirin for more than 3 years.
67.•
Wong BC, Zhang L, Ma JL, et al. Effects of selective COX-2 inhibitor and Helicobacter pylori eradication on precancerous gastric lesions. Gut. 2012;61(6):812–8. In this randomized controlled trial the effects of H. pylori eradication and COX-2 inhibitor treatment on gastric cancer risk were studied. H. pylori eradication results in a significant reduction, as does COX-2 inhibitors. No additional risk reduction was demonstrated in a combination of H. pylori eradication and COX-2 inhibitor use.
Metadata
Title
Gastric Cancer: How Can We Reduce the Incidence of this Disease?
Authors
Caroline M. den Hoed
Ernst J. Kuipers
Publication date
01-07-2016
Publisher
Springer US
Published in
Current Gastroenterology Reports / Issue 7/2016
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-016-0506-0

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