Screening and Prevention

Screening

Screening tests can be useful in detecting certain types of cancer at an early stage. Certain countries, such as Japan, where gastric cancer is much more common than in the United States, have screening programs for the general public. However, because gastric cancer is relatively uncommon in the United States, people without risk factors or symptoms are not routinely screened for this disease.

If you are at high risk of gastric cancer because you have certain risk factors (such as sporadic adenomas or familial adenomatous polyposis), your doctor might recommend that you be screened for gastric cancer on a regular basis.

This screening might include the following procedures:

• Upper endoscopy (gastroscopy) - An endoscope (or gastroscope) is a thick, flexible, lighted tube attached to a small camera. During an upper endoscopy, the doctor passes an endoscope down your throat and uses the instrument to see the lining of your esophagus and stomach. If the doctor sees any abnormal areas, he or she can remove tissue samples (perform a biopsy) using instruments passed through the endoscope.

If your doctor sees something suspicious in your stomach, he or she will do a biopsy. A biopsy is the only way to be sure whether you have gastric cancer.

• Biopsy - A biopsy involves cutting out a small piece of tissue and sending it to a laboratory. A pathologist (doctor who specializes in diagnosing diseases) will look at the tissue under a microscope to see whether it has cancer cells.

Certain kinds of x-rays are also used to screen people for gastric cancer:

• Upper gastrointestinal (GI) series (barium swallow, barium upper GI series, barium x-ray, stomach x-ray) - Before having this series of x-rays, you will drink a liquid that contains barium. The barium coats the lining of the esophagus, stomach, and intestines and makes tumors and other abnormalities show up more clearly on the x-rays. You will then have several x-rays taken. These x-rays are helpful in ruling out gastric cancer.
  

Prevention

Although the cause of stomach cancer is not known, you can take several steps to decrease your risk of developing this disease:

• Antibiotics for Helicobacter pylori infection - Some research shows that if you have a gastric ulcer (break in the stomach lining) or atrophic gastritis (in which the stomach lining is damaged) caused by the H. pylori bacteria, taking antibiotics could decrease the number of precancerous lesions in your stomach and reduce your risk of stomach cancer.
• Aspirin - Taking aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) reduces the risk of gastric cancer by at least 25 percent. However, these drugs can cause serious internal bleeding and other health risks in some people. It is not yet clear whether the benefits of reducing cancer risk by taking NSAIDs outweigh the bleeding complication risks for certain people.
• Diet - To reduce your risk of stomach cancer, you should avoid eating a lot of smoked or pickled foods and salted or processed meats and fish. In addition, you should eat whole grains and at least five servings of fruits and vegetables, especially those high in beta-carotene (found in yellow and orange fruits, and vegetables, including dark green leafy vegetables), lycopene (found in tomatoes, strawberries, and red peppers), and vitamin C every day.
• Dietary supplements - Research shows that taking certain antioxidant supplements (including selenium and vitamins A, C, and E) might reduce your risk of gastric cancer if you do not have a healthy diet.
• Genetic testing - If you have a strong family history of gastric cancer, you should have genetic testing to find out if you have abnormal genes that can predispose you to stomach cancer. If the genetic test results show that you have an abnormal form of the gene, your doctor might recommend that you have your stomach removed to prevent cancer.
• Limit alcohol consumption - To prevent gastric cancer, avoid drinking a lot of alcohol.
• Lose weight - Being obese or overweight could increase your risk of gastric cancer. Keep your weight at a healthy level by exercising enough to burn off the calories you eat.
• Stop smoking - Smoking significantly increases the risk of gastric cancer. To prevent gastric cancer, avoid smoking.

This content has been reviewed and approved by Myo Thant, MD.