Gastric cancer accounts for around 2% of all cancer diagnoses in the developed world, making it much less common than colorectal and slightly less common than oesophageal cancer. It is a cancer of older people (half of patients are > 75 years) are has a male predominance (2:1).

Most common gastric cancer is adenocarcinoma

Risk factors:

• Helicobacter pylori
  • triggers inflammation of the mucosa → atrophy and intestinal metaplasia
• atrophic gastritis
• diet
  • salt and salt-preserved foods
  • nitrates
• smoking
• blood group

PC

• abdominal pain (most common symptom)
  • typically vague, epigastric pain
  • may present as dyspepsia
• weight loss and anorexia
• nausea and vomiting
• dysphagia: particularly if the cancer arises in the proximal stomach
• overt upper gastrointestinal bleeding is seen only in a minority of patients
• if lymphatic spread:
  • left supraclavicular lymph node (Virchow's node)
  • periumbilical nodule (Sister Mary Joseph's node)
• It may present with ovarian masses

Associations: