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Stomach cancer - Wikipedia

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<span class="vector-toc-numb">2</span> <span>Risk factors</span> </div> </a> <button aria-controls="toc-Risk_factors-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Risk factors subsection</span> </button> <ul id="toc-Risk_factors-sublist" class="vector-toc-list"> <li id="toc-Infections" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Infections"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Infections</span> </div> </a> <ul id="toc-Infections-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Smoking" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Smoking"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Smoking</span> </div> </a> <ul id="toc-Smoking-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Alcohol" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Alcohol"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Alcohol</span> </div> </a> <ul id="toc-Alcohol-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Diet" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Diet"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Diet</span> </div> </a> <ul id="toc-Diet-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Genetics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Genetics"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.5</span> <span>Genetics</span> </div> </a> <ul id="toc-Genetics-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Diagnosis</span> </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Diagnosis subsection</span> </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Histopathology" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Histopathology"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Histopathology</span> </div> </a> <ul id="toc-Histopathology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Staging" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Staging"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Staging</span> </div> </a> <ul id="toc-Staging-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Management</span> </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Management subsection</span> </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Surgery</span> </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Chemotherapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Chemotherapy"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2</span> <span>Chemotherapy</span> </div> </a> <ul id="toc-Chemotherapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Targeted_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Targeted_therapy"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.3</span> <span>Targeted therapy</span> </div> </a> <ul id="toc-Targeted_therapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Radiation" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Radiation"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.4</span> <span>Radiation</span> </div> </a> <ul id="toc-Radiation-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lymphoma" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lymphoma"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.5</span> <span>Lymphoma</span> </div> </a> <ul id="toc-Lymphoma-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_animals" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Other_animals"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Other animals</span> </div> </a> <ul id="toc-Other_animals-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Stomach cancer</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 65 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-65" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">65 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B3%D8%B1%D8%B7%D8%A7%D9%86_%D8%A7%D9%84%D9%85%D8%B9%D8%AF%D8%A9" title="سرطان المعدة – Arabic" lang="ar" hreflang="ar" data-title="سرطان المعدة" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/M%C9%99d%C9%99_x%C9%99r%C3%A7%C9%99ngi" title="Mədə xərçəngi – Azerbaijani" lang="az" hreflang="az" data-title="Mədə xərçəngi" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D9%85%D8%B9%D8%AF%D9%87_%D8%B3%D8%B1%D8%B7%D8%A7%D9%86%DB%8C" title="معده سرطانی – South Azerbaijani" lang="azb" hreflang="azb" data-title="معده سرطانی" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%AA%E0%A6%BE%E0%A6%95%E0%A6%B8%E0%A7%8D%E0%A6%A5%E0%A6%B2%E0%A7%80%E0%A6%B0_%E0%A6%95%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%A8%E0%A7%8D%E0%A6%B8%E0%A6%BE%E0%A6%B0" title="পাকস্থলীর ক্যান্সার – Bangla" lang="bn" hreflang="bn" data-title="পাকস্থলীর ক্যান্সার" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%A0%D0%B0%D0%BA_%D1%81%D1%82%D1%80%D0%B0%D1%9E%D0%BD%D1%96%D0%BA%D0%B0" title="Рак страўніка – Belarusian" lang="be" hreflang="be" data-title="Рак страўніка" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%A0%D0%B0%D0%BA_%D1%81%D1%82%D1%80%D0%B0%D1%9E%D0%BD%D1%96%D0%BA%D0%B0" title="Рак страўніка – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Рак страўніка" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%A0%D0%B0%D0%BA_%D0%BD%D0%B0_%D1%81%D1%82%D0%BE%D0%BC%D0%B0%D1%85%D0%B0" title="Рак на стомаха – Bulgarian" lang="bg" hreflang="bg" data-title="Рак на стомаха" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Rak_%C5%BEeluca" title="Rak želuca – Bosnian" lang="bs" hreflang="bs" data-title="Rak želuca" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/C%C3%A0ncer_d%27est%C3%B3mac" title="Càncer d&#039;estómac – Catalan" lang="ca" hreflang="ca" data-title="Càncer d&#039;estómac" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cv mw-list-item"><a href="https://cv.wikipedia.org/wiki/%D0%A5%D1%8B%D1%80%C4%83%D0%BC%D0%BB%C4%83%D1%85_%D1%80%D0%B0%D0%BA%C4%95" title="Хырăмлăх ракĕ – Chuvash" lang="cv" hreflang="cv" data-title="Хырăмлăх ракĕ" data-language-autonym="Чӑвашла" data-language-local-name="Chuvash" class="interlanguage-link-target"><span>Чӑвашла</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Karcinom_%C5%BEaludku" title="Karcinom žaludku – Czech" lang="cs" hreflang="cs" data-title="Karcinom žaludku" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Ventrikelcancer" title="Ventrikelcancer – Danish" lang="da" hreflang="da" data-title="Ventrikelcancer" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Magenkarzinom" title="Magenkarzinom – German" lang="de" hreflang="de" data-title="Magenkarzinom" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%89%DE%A6%DE%87%DE%A8%DE%8B%DE%A7%DE%8E%DE%AC_%DE%86%DE%AC%DE%82%DE%B0%DE%90%DE%A6%DE%83%DE%AA" title="މައިދާގެ ކެންސަރު – Divehi" lang="dv" hreflang="dv" data-title="މައިދާގެ ކެންސަރު" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target"><span>ދިވެހިބަސް</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Maov%C3%A4hk" title="Maovähk – Estonian" lang="et" hreflang="et" data-title="Maovähk" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%9A%CE%B1%CF%81%CE%BA%CE%AF%CE%BD%CE%BF%CF%82_%CF%84%CE%BF%CF%85_%CF%83%CF%84%CE%BF%CE%BC%CE%AC%CF%87%CE%BF%CF%85" title="Καρκίνος του στομάχου – Greek" lang="el" hreflang="el" data-title="Καρκίνος του στομάχου" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/C%C3%A1ncer_de_est%C3%B3mago" title="Cáncer de estómago – Spanish" lang="es" hreflang="es" data-title="Cáncer de estómago" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Stomaka_kancero" title="Stomaka kancero – Esperanto" lang="eo" hreflang="eo" data-title="Stomaka kancero" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Urdaileko_minbizi" title="Urdaileko minbizi – Basque" lang="eu" hreflang="eu" data-title="Urdaileko minbizi" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%D8%B1%D8%B7%D8%A7%D9%86_%D9%85%D8%B9%D8%AF%D9%87" title="سرطان معده – Persian" lang="fa" hreflang="fa" data-title="سرطان معده" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Cancer_de_l%27estomac" title="Cancer de l&#039;estomac – French" lang="fr" hreflang="fr" data-title="Cancer de l&#039;estomac" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Ailse_ghoile" title="Ailse ghoile – Irish" lang="ga" hreflang="ga" data-title="Ailse ghoile" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Cancro_de_est%C3%B3mago" title="Cancro de estómago – Galician" lang="gl" hreflang="gl" data-title="Cancro de estómago" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%9C%84%EC%95%94" title="위암 – Korean" lang="ko" hreflang="ko" data-title="위암" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%8D%D5%BF%D5%A1%D5%B4%D5%B8%D6%84%D5%BD%D5%AB_%D6%84%D5%A1%D5%B2%D6%81%D5%AF%D5%A5%D5%B2" title="Ստամոքսի քաղցկեղ – Armenian" lang="hy" hreflang="hy" data-title="Ստամոքսի քաղցկեղ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Rak_%C5%BEeludca" title="Rak želudca – Croatian" lang="hr" hreflang="hr" data-title="Rak želudca" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Kanker_lambung" title="Kanker lambung – Indonesian" lang="id" hreflang="id" data-title="Kanker lambung" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Tumore_dello_stomaco" title="Tumore dello stomaco – Italian" lang="it" hreflang="it" data-title="Tumore dello stomaco" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A1%D7%A8%D7%98%D7%9F_%D7%94%D7%A7%D7%99%D7%91%D7%94" title="סרטן הקיבה – Hebrew" lang="he" hreflang="he" data-title="סרטן הקיבה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%90%D0%B4%D0%B5%D0%BD%D0%BE%D0%BA%D0%B0%D1%80%D1%86%D0%B8%D0%BD%D0%BE%D0%BC%D0%B0" title="Аденокарцинома – Kazakh" lang="kk" hreflang="kk" data-title="Аденокарцинома" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Cancer_stomachi" title="Cancer stomachi – Latin" lang="la" hreflang="la" data-title="Cancer stomachi" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Skrand%C5%BEio_adenokarcinoma" title="Skrandžio adenokarcinoma – Lithuanian" lang="lt" hreflang="lt" data-title="Skrandžio adenokarcinoma" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Gyomorr%C3%A1k" title="Gyomorrák – Hungarian" lang="hu" hreflang="hu" data-title="Gyomorrák" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%A0%D0%B0%D0%BA_%D0%BD%D0%B0_%D0%B6%D0%B5%D0%BB%D1%83%D0%B4%D0%BD%D0%B8%D0%BA" title="Рак на желудник – Macedonian" lang="mk" hreflang="mk" data-title="Рак на желудник" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%9C%E0%A4%A0%E0%A4%B0%E0%A4%BE%E0%A4%9A%E0%A4%BE_%E0%A4%95%E0%A4%B0%E0%A5%8D%E0%A4%95%E0%A4%B0%E0%A5%8B%E0%A4%97" title="जठराचा कर्करोग – Marathi" lang="mr" hreflang="mr" data-title="जठराचा कर्करोग" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target"><span>मराठी</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Barah_perut" title="Barah perut – Malay" lang="ms" hreflang="ms" data-title="Barah perut" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Maagkanker" title="Maagkanker – Dutch" lang="nl" hreflang="nl" data-title="Maagkanker" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%83%83%E7%99%8C" title="胃癌 – Japanese" lang="ja" hreflang="ja" data-title="胃癌" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Magekreft" title="Magekreft – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Magekreft" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%AA%E0%AC%BE%E0%AC%95%E0%AC%B8%E0%AD%8D%E0%AC%A5%E0%AC%B3%E0%AD%80_%E0%AC%95%E0%AC%B0%E0%AD%8D%E0%AC%95%E0%AC%9F" title="ପାକସ୍ଥଳୀ କର୍କଟ – Odia" lang="or" hreflang="or" data-title="ପାକସ୍ଥଳୀ କର୍କଟ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Oshqozon_saratoni" title="Oshqozon saratoni – Uzbek" lang="uz" hreflang="uz" data-title="Oshqozon saratoni" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pa mw-list-item"><a href="https://pa.wikipedia.org/wiki/%E0%A8%A2%E0%A8%BF%E0%A9%B1%E0%A8%A1_%E0%A8%A6%E0%A8%BE_%E0%A8%95%E0%A9%88%E0%A8%82%E0%A8%B8%E0%A8%B0" title="ਢਿੱਡ ਦਾ ਕੈਂਸਰ – Punjabi" lang="pa" hreflang="pa" data-title="ਢਿੱਡ ਦਾ ਕੈਂਸਰ" data-language-autonym="ਪੰਜਾਬੀ" data-language-local-name="Punjabi" class="interlanguage-link-target"><span>ਪੰਜਾਬੀ</span></a></li><li class="interlanguage-link interwiki-ps mw-list-item"><a href="https://ps.wikipedia.org/wiki/%D8%AF_%D9%85%D8%B9%D8%AF%DB%8C_%D8%B3%D8%B1%D8%B7%D8%A7%D9%86" title="د معدی سرطان – Pashto" lang="ps" hreflang="ps" data-title="د معدی سرطان" data-language-autonym="پښتو" data-language-local-name="Pashto" class="interlanguage-link-target"><span>پښتو</span></a></li><li class="interlanguage-link interwiki-pl badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://pl.wikipedia.org/wiki/Rak_%C5%BCo%C5%82%C4%85dka_cz%C5%82owieka" title="Rak żołądka człowieka – Polish" lang="pl" hreflang="pl" data-title="Rak żołądka człowieka" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Cancro_do_est%C3%B4mago" title="Cancro do estômago – Portuguese" lang="pt" hreflang="pt" data-title="Cancro do estômago" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Cancer_stomacal" title="Cancer stomacal – Romanian" lang="ro" hreflang="ro" data-title="Cancer stomacal" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A0%D0%B0%D0%BA_%D0%B6%D0%B5%D0%BB%D1%83%D0%B4%D0%BA%D0%B0" title="Рак желудка – Russian" lang="ru" hreflang="ru" data-title="Рак желудка" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sat mw-list-item"><a href="https://sat.wikipedia.org/wiki/%E1%B1%9E%E1%B1%9F%E1%B1%A1_%E1%B1%A0%E1%B1%AE%E1%B1%B1%E1%B1%A5%E1%B1%9F%E1%B1%A8" title="ᱞᱟᱡ ᱠᱮᱱᱥᱟᱨ – Santali" lang="sat" hreflang="sat" data-title="ᱞᱟᱡ ᱠᱮᱱᱥᱟᱨ" data-language-autonym="ᱥᱟᱱᱛᱟᱲᱤ" data-language-local-name="Santali" class="interlanguage-link-target"><span>ᱥᱟᱱᱛᱟᱲᱤ</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Stomach_cancer" title="Stomach cancer – Simple English" lang="en-simple" hreflang="en-simple" data-title="Stomach cancer" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Rakovina_%C5%BEal%C3%BAdka" title="Rakovina žalúdka – Slovak" lang="sk" hreflang="sk" data-title="Rakovina žalúdka" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Rak_%C5%BEelodca" title="Rak želodca – Slovenian" lang="sl" hreflang="sl" data-title="Rak želodca" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%B4%DB%8E%D8%B1%D9%BE%DB%95%D9%86%D8%AC%DB%95%DB%8C_%DA%AF%DB%95%D8%AF%DB%95" title="شێرپەنجەی گەدە – Central Kurdish" lang="ckb" hreflang="ckb" data-title="شێرپەنجەی گەدە" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A0%D0%B0%D0%BA_%D0%B6%D0%B5%D0%BB%D1%83%D1%86%D0%B0" title="Рак желуца – Serbian" lang="sr" hreflang="sr" data-title="Рак желуца" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Mahasy%C3%B6p%C3%A4" title="Mahasyöpä – Finnish" lang="fi" hreflang="fi" data-title="Mahasyöpä" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Mags%C3%A4ckscancer" title="Magsäckscancer – Swedish" lang="sv" hreflang="sv" data-title="Magsäckscancer" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%87%E0%AE%B0%E0%AF%88%E0%AE%AA%E0%AF%8D%E0%AE%AA%E0%AF%88%E0%AE%AA%E0%AF%8D_%E0%AE%AA%E0%AF%81%E0%AE%B1%E0%AF%8D%E0%AE%B1%E0%AF%81%E0%AE%A8%E0%AF%8B%E0%AE%AF%E0%AF%8D" title="இரைப்பைப் புற்றுநோய் – Tamil" lang="ta" hreflang="ta" data-title="இரைப்பைப் புற்றுநோய்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-te mw-list-item"><a href="https://te.wikipedia.org/wiki/%E0%B0%9C%E0%B1%80%E0%B0%B0%E0%B1%8D%E0%B0%A3%E0%B0%BE%E0%B0%B6%E0%B0%AF_%E0%B0%95%E0%B1%8D%E0%B0%AF%E0%B0%BE%E0%B0%A8%E0%B1%8D%E0%B0%B8%E0%B0%B0%E0%B1%8D" title="జీర్ణాశయ క్యాన్సర్ – Telugu" lang="te" hreflang="te" data-title="జీర్ణాశయ క్యాన్సర్" data-language-autonym="తెలుగు" data-language-local-name="Telugu" class="interlanguage-link-target"><span>తెలుగు</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Mide_kanseri" title="Mide kanseri – Turkish" lang="tr" hreflang="tr" data-title="Mide kanseri" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A0%D0%B0%D0%BA_%D1%88%D0%BB%D1%83%D0%BD%D0%BA%D0%B0" title="Рак шлунка – Ukrainian" lang="uk" hreflang="uk" data-title="Рак шлунка" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-za mw-list-item"><a href="https://za.wikipedia.org/wiki/Aizcwng_dungx" title="Aizcwng dungx – Zhuang" lang="za" hreflang="za" data-title="Aizcwng dungx" data-language-autonym="Vahcuengh" data-language-local-name="Zhuang" class="interlanguage-link-target"><span>Vahcuengh</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Ung_th%C6%B0_d%E1%BA%A1_d%C3%A0y" title="Ung thư dạ dày – Vietnamese" lang="vi" hreflang="vi" data-title="Ung thư dạ dày" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E8%83%83%E7%99%8C" title="胃癌 – Wu" lang="wuu" hreflang="wuu" data-title="胃癌" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target"><span>吴语</span></a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E8%83%83%E7%99%8C" title="胃癌 – Cantonese" lang="yue" hreflang="yue" data-title="胃癌" data-language-autonym="粵語" data-language-local-name="Cantonese" class="interlanguage-link-target"><span>粵語</span></a></li><li class="interlanguage-link interwiki-diq mw-list-item"><a href="https://diq.wikipedia.org/wiki/Qanser%C3%AA_pizey" title="Qanserê pizey – Zazaki" lang="diq" hreflang="diq" data-title="Qanserê pizey" data-language-autonym="Zazaki" data-language-local-name="Zazaki" class="interlanguage-link-target"><span>Zazaki</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E8%83%83%E7%99%8C" title="胃癌 – Chinese" lang="zh" hreflang="zh" data-title="胃癌" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q189588#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div class="vector-page-toolbar"> <div class="vector-page-toolbar-container"> <div id="left-navigation"> <nav 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style="display:none">Cancerous tumor originating in the stomach lining</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Stomach cancer</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Gastric cancer</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Adenocarcinoma_of_the_stomach.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/94/Adenocarcinoma_of_the_stomach.jpg/220px-Adenocarcinoma_of_the_stomach.jpg" decoding="async" width="220" height="140" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/94/Adenocarcinoma_of_the_stomach.jpg/330px-Adenocarcinoma_of_the_stomach.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/94/Adenocarcinoma_of_the_stomach.jpg/440px-Adenocarcinoma_of_the_stomach.jpg 2x" data-file-width="600" data-file-height="381" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">A <a href="/wiki/Stomach_ulcer" class="mw-redirect" title="Stomach ulcer">stomach ulcer</a> that was diagnosed as cancer on <a href="/wiki/Biopsy" title="Biopsy">biopsy</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Gastroenterology" title="Gastroenterology">Gastroenterology</a> <a href="/wiki/Oncology" title="Oncology">Oncology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data"><b>Early</b>: <style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><div class="hlist"><ul><li><a href="/wiki/Heartburn" title="Heartburn">Heartburn</a></li><li><a href="/wiki/Bloating" title="Bloating">bloating</a></li><li>upper <a href="/wiki/Abdominal_pain" title="Abdominal pain">abdominal pain</a></li><li><a href="/wiki/Nausea" title="Nausea">nausea</a></li><li><a href="/wiki/Burping" title="Burping">belching</a></li><li><a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">loss of appetite</a><sup id="cite_ref-NCI2014TxPt_1-0" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></li></ul></div><b>Later</b>: <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><div class="hlist"><ul><li><a href="/wiki/Weight_loss" title="Weight loss">Weight loss</a></li><li><a href="/wiki/Jaundice" title="Jaundice">yellowing of the skin and whites of the eyes</a></li><li><a href="/wiki/Hematemesis" title="Hematemesis">vomiting blood</a></li><li><a href="/wiki/Dysphagia" title="Dysphagia">difficulty swallowing</a></li><li><a href="/wiki/Melena" title="Melena">blood in the stool</a><sup id="cite_ref-NCI2014TxPt_1-1" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></li></ul></div></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">Over years<sup id="cite_ref-WCR2014_2-0" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Types</th><td class="infobox-data">Gastric carcinomas, <a href="/wiki/Lymphoma" title="Lymphoma">lymphoma</a>, <a href="/wiki/Mesenchymal_tumor" class="mw-redirect" title="Mesenchymal tumor">mesenchymal tumor</a><sup id="cite_ref-WCR2014_2-1" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data"><i><a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">Helicobacter pylori</a></i>, <a href="/wiki/Genetics" title="Genetics">genetics</a><sup id="cite_ref-WCR2014_2-2" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-ChangParsonnet2010_3-0" class="reference"><a href="#cite_note-ChangParsonnet2010-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data">Smoking, dietary factors such as <a href="/wiki/Pickled_vegetables" class="mw-redirect" title="Pickled vegetables">pickled vegetables</a>, <a href="/wiki/Obesity" title="Obesity">obesity</a><sup id="cite_ref-WCR2014_2-3" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid24011243_4-0" class="reference"><a href="#cite_note-pmid24011243-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data"><a href="/wiki/Biopsy" title="Biopsy">Biopsy</a> done during <a href="/wiki/Endoscopy" title="Endoscopy">endoscopy</a><sup id="cite_ref-NCI2014TxPt_1-2" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data"><a href="/wiki/Mediterranean_diet" title="Mediterranean diet">Mediterranean diet</a>, not smoking<sup id="cite_ref-WCR2014_2-4" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-NCI2014Prevent_5-0" class="reference"><a href="#cite_note-NCI2014Prevent-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data">Surgery, <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a>, <a href="/wiki/Targeted_therapy" title="Targeted therapy">targeted therapy</a><sup id="cite_ref-NCI2014TxPt_1-3" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data"><a href="/wiki/Five-year_survival_rate" title="Five-year survival rate">Five-year survival rate</a>:<br />&lt; 10% (advanced cases),<sup id="cite_ref-WJG14_6-0" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup><br />32% (US),<sup id="cite_ref-SEER2020_7-0" class="reference"><a href="#cite_note-SEER2020-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> 71% (Japan)<sup id="cite_ref-Jap2011_8-0" class="reference"><a href="#cite_note-Jap2011-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">968,350 (2022)<sup id="cite_ref-Bray2022_9-0" class="reference"><a href="#cite_note-Bray2022-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Deaths</th><td class="infobox-data">659,853 (2022)<sup id="cite_ref-Bray2022_9-1" class="reference"><a href="#cite_note-Bray2022-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup></td></tr></tbody></table> <p><b>Stomach cancer</b>, also known as <b>gastric cancer</b>, is a <a href="/wiki/Cancer" title="Cancer">cancer</a> that develops from the <a href="/wiki/Gastric_mucosa" title="Gastric mucosa">lining of the stomach</a>.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> Most cases of stomach cancers are gastric <a href="/wiki/Carcinomas" class="mw-redirect" title="Carcinomas">carcinomas</a>, which can be divided into a number of subtypes, including gastric <a href="/wiki/Adenocarcinomas" class="mw-redirect" title="Adenocarcinomas">adenocarcinomas</a>.<sup id="cite_ref-WCR2014_2-5" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Lymphomas" class="mw-redirect" title="Lymphomas">Lymphomas</a> and <a href="/wiki/Mesenchymal_tumors" class="mw-redirect" title="Mesenchymal tumors">mesenchymal tumors</a> may also develop in the stomach.<sup id="cite_ref-WCR2014_2-6" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Early symptoms may include <a href="/wiki/Heartburn" title="Heartburn">heartburn</a>, upper abdominal pain, <a href="/wiki/Nausea" title="Nausea">nausea</a>, and <a href="/wiki/Anorexia_(symptom)" title="Anorexia (symptom)">loss of appetite</a>.<sup id="cite_ref-NCI2014TxPt_1-4" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> Later signs and symptoms may include <a href="/wiki/Weight_loss" title="Weight loss">weight loss</a>, <a href="/wiki/Jaundice" title="Jaundice">yellowing of the skin and whites of the eyes</a>, <a href="/wiki/Hematemesis" title="Hematemesis">vomiting</a>, <a href="/wiki/Dysphagia" title="Dysphagia">difficulty swallowing</a>, and <a href="/wiki/Melena" title="Melena">blood in the stool</a>, among others.<sup id="cite_ref-NCI2014TxPt_1-5" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> The cancer may <a href="/wiki/Metastasis" title="Metastasis">spread</a> from the stomach to other parts of the body, particularly the <a href="/wiki/Liver" title="Liver">liver</a>, <a href="/wiki/Lungs" class="mw-redirect" title="Lungs">lungs</a>, <a href="/wiki/Bone" title="Bone">bones</a>, <a href="/wiki/Peritoneum" title="Peritoneum">lining of the abdomen</a>, and <a href="/wiki/Lymph_node" title="Lymph node">lymph nodes</a>.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> </p><p>The <a href="/wiki/Bacterium" class="mw-redirect" title="Bacterium">bacterium</a> <i><a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">Helicobacter pylori</a></i> accounts for more than 60% of cases of stomach cancer<sup id="cite_ref-WCR2014_2-7" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-ChangParsonnet2010_3-1" class="reference"><a href="#cite_note-ChangParsonnet2010-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> Certain strains of <i>H. pylori</i> have greater risks than others.<sup id="cite_ref-WCR2014_2-8" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Smoking, dietary factors such as <a href="/wiki/Pickled_vegetables" class="mw-redirect" title="Pickled vegetables">pickled vegetables</a> and <a href="/wiki/Obesity" title="Obesity">obesity</a> are other risk factors.<sup id="cite_ref-WCR2014_2-9" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid24011243_4-1" class="reference"><a href="#cite_note-pmid24011243-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> About 10% of cases run in families, and between 1% and 3% of cases are due to <a href="/wiki/Cancer_syndrome" class="mw-redirect" title="Cancer syndrome">genetic syndromes</a> <a href="/wiki/Heredity" title="Heredity">inherited</a> such as <a href="/wiki/Hereditary_diffuse_gastric_cancer" title="Hereditary diffuse gastric cancer">hereditary diffuse gastric cancer</a>.<sup id="cite_ref-WCR2014_2-10" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Most of the time, stomach cancer develops in stages over years.<sup id="cite_ref-WCR2014_2-11" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Diagnosis is usually by <a href="/wiki/Biopsy" title="Biopsy">biopsy</a> done during <a href="/wiki/Endoscopy" title="Endoscopy">endoscopy</a>.<sup id="cite_ref-NCI2014TxPt_1-6" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> This is followed by <a href="/wiki/Medical_imaging" title="Medical imaging">medical imaging</a> to determine if the disease has spread to other parts of the body.<sup id="cite_ref-NCI2014TxPt_1-7" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Japan" title="Japan">Japan</a> and <a href="/wiki/South_Korea" title="South Korea">South Korea</a>, two countries that have high rates of the disease, <a href="/wiki/Cancer_screening" title="Cancer screening">screen for stomach cancer</a>.<sup id="cite_ref-WCR2014_2-12" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> </p><p>A <a href="/wiki/Mediterranean_diet" title="Mediterranean diet">Mediterranean diet</a> lowers the risk of stomach cancer, as does not smoking.<sup id="cite_ref-WCR2014_2-13" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-NCI2014Prevent_5-1" class="reference"><a href="#cite_note-NCI2014Prevent-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> Tentative evidence indicates that treating <i><a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">H. pylori</a></i> decreases the future risk.<sup id="cite_ref-WCR2014_2-14" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-NCI2014Prevent_5-2" class="reference"><a href="#cite_note-NCI2014Prevent-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> If stomach cancer is treated early, it can be cured.<sup id="cite_ref-WCR2014_2-15" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Treatments may include some combination of surgery, <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a>, and <a href="/wiki/Targeted_therapy" title="Targeted therapy">targeted therapy</a>.<sup id="cite_ref-NCI2014TxPt_1-8" class="reference"><a href="#cite_note-NCI2014TxPt-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Wagner17_13-0" class="reference"><a href="#cite_note-Wagner17-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> For certain subtypes of gastric cancer, <a href="/wiki/Cancer_immunotherapy" title="Cancer immunotherapy">cancer immunotherapy</a> is an option as well.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">&#91;</span>14<span class="cite-bracket">&#93;</span></a></sup> If treated late, <a href="/wiki/Palliative_care" title="Palliative care">palliative care</a> may be advised.<sup id="cite_ref-WCR2014_2-16" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Some types of lymphoma can be cured by eliminating <i>H. pylori</i>.<sup id="cite_ref-St2010_15-0" class="reference"><a href="#cite_note-St2010-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> Outcomes are often poor, with a less than 10% <a href="/wiki/Five-year_survival_rate" title="Five-year survival rate">five-year survival rate</a> in the Western world for advanced cases.<sup id="cite_ref-WJG14_6-1" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> This is largely because most people with the condition present with advanced disease.<sup id="cite_ref-WJG14_6-2" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> In the United States, five-year survival is 31.5%,<sup id="cite_ref-SEER2020_7-1" class="reference"><a href="#cite_note-SEER2020-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> while in South Korea it is over 65% and Japan over 70%, partly due to screening efforts.<sup id="cite_ref-WCR2014_2-17" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Jap2011_8-1" class="reference"><a href="#cite_note-Jap2011-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> </p><p>Globally, stomach cancer is the fifth-leading type of cancer and the third-leading cause of death from cancer, making up 7% of cases and 9% of deaths.<sup id="cite_ref-WCR2014Epi_16-0" class="reference"><a href="#cite_note-WCR2014Epi-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> In 2018, it newly occurred in 1.03 million people and caused 783,000 deaths.<sup id="cite_ref-Bray2018_17-0" class="reference"><a href="#cite_note-Bray2018-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> Before the 1930s, it was a leading cause of cancer deaths in the <a href="/wiki/Western_countries" class="mw-redirect" title="Western countries">Western world</a>, however rates have sharply declined among younger generations in the West, while they remain high for people living in East Asia.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup> The decline in the West is believed to be due to the decline of salted and pickled food consumption, as a result of the development of <a href="/wiki/Refrigeration" title="Refrigeration">refrigeration</a> as a method of preserving food.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> Stomach cancer occurs most commonly in <a href="/wiki/East_Asia" title="East Asia">East Asia</a>, followed by <a href="/wiki/Eastern_Europe" title="Eastern Europe">Eastern Europe</a>.<sup id="cite_ref-WCR2014_2-18" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> It occurs twice as often in males as in females.<sup id="cite_ref-WCR2014_2-19" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Linitis_plastica_2.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/94/Linitis_plastica_2.jpg/220px-Linitis_plastica_2.jpg" decoding="async" width="220" height="202" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/94/Linitis_plastica_2.jpg/330px-Linitis_plastica_2.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/94/Linitis_plastica_2.jpg/440px-Linitis_plastica_2.jpg 2x" data-file-width="631" data-file-height="580" /></a><figcaption>Endoscopic image of <a href="/wiki/Linitis_plastica" title="Linitis plastica">linitis plastica</a>, a type of stomach cancer where the entire <a href="/wiki/Stomach" title="Stomach">stomach</a> is invaded, leading to a leather bottle-like appearance with <a href="/wiki/Bleeding" title="Bleeding">blood</a> coming out of it</figcaption></figure> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Por-sig.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/fd/Por-sig.jpg/220px-Por-sig.jpg" decoding="async" width="220" height="217" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/fd/Por-sig.jpg/330px-Por-sig.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/fd/Por-sig.jpg/440px-Por-sig.jpg 2x" data-file-width="1388" data-file-height="1368" /></a><figcaption>Endoscopic images of the stomach <a href="/wiki/Cancer" title="Cancer">cancer</a> in early stage. Its histology was poorly differentiated <a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">adenocarcinoma</a> with <a href="/wiki/Signet_ring_cells" class="mw-redirect" title="Signet ring cells">signet ring cells</a>. Left above: normal, right above: FICE, left low: acetate stained, right low: AIM stained</figcaption></figure> <p>Stomach cancer is often either <a href="/wiki/Asymptomatic" title="Asymptomatic">asymptomatic</a> (producing no noticeable symptoms) or it may cause only <a href="/wiki/Nonspecific_symptoms" class="mw-redirect" title="Nonspecific symptoms">nonspecific symptoms</a> (which may also be present in other related or unrelated disorders) in its early stages. By the time symptoms are recognized, the cancer has often reached an advanced stage (see below) and may have metastasized (spread to other, perhaps distant, parts of the body), which is one of the main reasons for its relatively poor prognosis.<sup id="cite_ref-SAOGC_22-0" class="reference"><a href="#cite_note-SAOGC-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> Stomach cancer can cause the following signs and symptoms: Unexplained nausea, vomiting, diarrhoea and constipation. Patients also can experience unexplained weight loss.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> </p><p>Early cancers may be associated with <a href="/wiki/Indigestion" title="Indigestion">indigestion</a> or a burning sensation (<a href="/wiki/Heartburn" title="Heartburn">heartburn</a>). However, fewer than one in every 50 people referred for endoscopy due to indigestion has cancer.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Abdominal_pain" title="Abdominal pain">Abdominal discomfort</a> and <a href="/wiki/Loss_of_appetite" class="mw-redirect" title="Loss of appetite">loss of appetite</a> can occur.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup> </p><p>Gastric cancers that have enlarged and invaded normal tissue can cause <a href="/wiki/Weakness" title="Weakness">weakness</a>, <a href="/wiki/Fatigue_(physical)" class="mw-redirect" title="Fatigue (physical)">fatigue</a>, <a href="/wiki/Bloating" title="Bloating">bloating</a> of the stomach after meals, <a href="/wiki/Abdominal_pain" title="Abdominal pain">abdominal pain</a> in the upper abdomen, <a href="/wiki/Nausea" title="Nausea">nausea</a> and occasional <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>. Further enlargement may cause <a href="/wiki/Weight_loss" title="Weight loss">weight loss</a> or <a href="/wiki/Bleeding" title="Bleeding">bleeding</a> with <a href="/wiki/Vomiting_blood" class="mw-redirect" title="Vomiting blood">vomiting blood</a> or having <a href="/wiki/Blood_in_the_stool" class="mw-redirect" title="Blood in the stool">blood in the stool</a>, the latter apparent as black discolouration (<a href="/wiki/Melena" title="Melena">melena</a>) and sometimes leading to <a href="/wiki/Anemia" title="Anemia">anemia</a>. <a href="/wiki/Dysphagia" title="Dysphagia">Dysphagia</a> suggests a tumour in the <a href="/wiki/Cardia" class="mw-redirect" title="Cardia">cardia</a> or extension of the gastric tumour into the <a href="/wiki/Esophagus" title="Esophagus">esophagus</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p><p>These can be symptoms of other problems such as a <a href="/wiki/Stomach_virus" class="mw-redirect" title="Stomach virus">stomach virus</a>, <a href="/wiki/Gastric_ulcer" class="mw-redirect" title="Gastric ulcer">gastric ulcer</a>, or <a href="/wiki/Tropical_sprue" title="Tropical sprue">tropical sprue</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Risk_factors">Risk factors</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=2" title="Edit section: Risk factors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Gastric cancer can occur as a result of many factors.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> It occurs twice as commonly in males as females. <a href="/wiki/Estrogen" title="Estrogen">Estrogen</a> may protect women against the development of this form of cancer.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">&#91;</span>28<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Infections">Infections</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=3" title="Edit section: Infections"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><i><a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">Helicobacter pylori</a></i> infection is an essential risk factor in 65–80% of gastric cancers, but only 2% of people with <i>H. pylori</i> infections develop stomach cancer.<sup id="cite_ref-pmid24011243_4-2" class="reference"><a href="#cite_note-pmid24011243-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-GVRF-4_30-0" class="reference"><a href="#cite_note-GVRF-4-30"><span class="cite-bracket">&#91;</span>30<span class="cite-bracket">&#93;</span></a></sup> The mechanism by which <i>H. pylori</i> induces stomach cancer potentially involves chronic inflammation, the action of <i>H. pylori</i> virulence factors such as <a href="/wiki/CagA" class="mw-redirect" title="CagA">CagA</a>,<sup id="cite_ref-pmid16367902_31-0" class="reference"><a href="#cite_note-pmid16367902-31"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup> or an interaction between <i>H. pylori</i> infection and germline pathogenic variants in homologous-recombination genes.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup> It was estimated that <a href="/wiki/Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a> is responsible for 84,000 cases per year.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">&#91;</span>33<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/AIDS" class="mw-redirect" title="AIDS">AIDS</a> is also associated with elevated risk.<sup id="cite_ref-pmid24011243_4-3" class="reference"><a href="#cite_note-pmid24011243-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Smoking">Smoking</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=4" title="Edit section: Smoking"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Smoking increases the risk of developing gastric cancer significantly, from 40% increased risk for current smokers to 82% increase for heavy smokers. Gastric cancers due to smoking mostly occur in the upper part of the stomach near the esophagus.<sup id="cite_ref-ACS_Risk_34-0" class="reference"><a href="#cite_note-ACS_Risk-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Alcohol">Alcohol</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=5" title="Edit section: Alcohol"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some studies show <a href="/wiki/Alcohol_and_cancer" title="Alcohol and cancer">increased risk with alcohol consumption</a> as well.<sup id="cite_ref-pmid24011243_4-4" class="reference"><a href="#cite_note-pmid24011243-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid24191271_37-0" class="reference"><a href="#cite_note-pmid24191271-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Diet">Diet</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=6" title="Edit section: Diet"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Dietary factors are not proven causes, and the association between stomach cancer and various foods and beverages is weak.<sup id="cite_ref-Theodoratou2017_38-0" class="reference"><a href="#cite_note-Theodoratou2017-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> Some foods including <a href="/wiki/Fried_foods" class="mw-redirect" title="Fried foods">fried foods</a>,<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">&#91;</span>39<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Smoked_foods" class="mw-redirect" title="Smoked foods">smoked foods</a>, <a href="/wiki/Salt" title="Salt">salt</a> and <a href="/wiki/Low_sodium_diet#High_sodium_content" title="Low sodium diet">salt-rich foods</a>, <a href="/wiki/Meat" title="Meat">meat</a>,<sup id="cite_ref-ferro-meat_40-0" class="reference"><a href="#cite_note-ferro-meat-40"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Processed_meat" title="Processed meat">processed meat</a>,<sup id="cite_ref-ferro-meat_40-1" class="reference"><a href="#cite_note-ferro-meat-40"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Red_meat" title="Red meat">red meat</a>,<sup id="cite_ref-ferro-meat_40-2" class="reference"><a href="#cite_note-ferro-meat-40"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Pickled_vegetables" class="mw-redirect" title="Pickled vegetables">pickled vegetables</a>, and <a href="/wiki/Bracken" title="Bracken">brackens</a><sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">&#91;</span>41<span class="cite-bracket">&#93;</span></a></sup> are <a href="/wiki/Association_(statistics)" class="mw-redirect" title="Association (statistics)">associated</a> with a higher risk of stomach cancer.<sup id="cite_ref-pmid24011243_4-5" class="reference"><a href="#cite_note-pmid24011243-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid16865769_42-0" class="reference"><a href="#cite_note-pmid16865769-42"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup> </p><p>Fresh fruit and vegetable intake,<sup id="cite_ref-ferro-fruits_43-0" class="reference"><a href="#cite_note-ferro-fruits-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup> citrus fruit intake,<sup id="cite_ref-ferro-fruits_43-1" class="reference"><a href="#cite_note-ferro-fruits-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup> and <a href="/wiki/Antioxidant" title="Antioxidant">antioxidant</a> intake are associated with a lower risk of stomach cancer.<sup id="cite_ref-pmid24011243_4-6" class="reference"><a href="#cite_note-pmid24011243-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-ACS_Risk_34-1" class="reference"><a href="#cite_note-ACS_Risk-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> A Mediterranean diet is associated with lower rates of stomach cancer,<sup id="cite_ref-American_Journal_of_Clinical_Nutrition_44-0" class="reference"><a href="#cite_note-American_Journal_of_Clinical_Nutrition-44"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup> as is regular <a href="/wiki/Aspirin" title="Aspirin">aspirin</a> use.<sup id="cite_ref-pmid24011243_4-7" class="reference"><a href="#cite_note-pmid24011243-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> </p><p>Obesity is a physical risk factor that has been found to increase the risk of gastric adenocarcinoma by contributing to the development of <a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastroesophageal reflux disease</a> (GERD).<sup id="cite_ref-crew_45-0" class="reference"><a href="#cite_note-crew-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup> The exact mechanism by which obesity causes GERD is not completely known. Studies hypothesize that increased dietary fat leading to increased pressure on the stomach and the lower esophageal sphincter, due to excess adipose tissue, could play a role, yet no statistically significant data have been collected.<sup id="cite_ref-hamp_46-0" class="reference"><a href="#cite_note-hamp-46"><span class="cite-bracket">&#91;</span>46<span class="cite-bracket">&#93;</span></a></sup> However, the risk of gastric cardia adenocarcinoma, with GERD present, has been found to increase more than two times for an obese person.<sup id="cite_ref-crew_45-1" class="reference"><a href="#cite_note-crew-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup> There is a correlation between <a href="/wiki/Iodine_deficiency" title="Iodine deficiency">iodine deficiency</a> and gastric cancer.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">&#91;</span>47<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Genetics">Genetics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=7" title="Edit section: Genetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>About 10% of cases run in families, and between 1 and 3% of cases are due to <a href="/wiki/Genetic_syndrome" class="mw-redirect" title="Genetic syndrome">genetic syndromes</a> <a href="/wiki/Heredity" title="Heredity">inherited</a> such as <a href="/wiki/Hereditary_diffuse_gastric_cancer" title="Hereditary diffuse gastric cancer">hereditary diffuse gastric cancer</a>.<sup id="cite_ref-WCR2014_2-20" class="reference"><a href="#cite_note-WCR2014-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> </p><p>A genetic risk factor for gastric cancer is a genetic defect of the <a href="/wiki/CDH1_(gene)" class="mw-redirect" title="CDH1 (gene)"><i>CDH1</i> gene</a> known as <a href="/wiki/Hereditary_diffuse_gastric_cancer" title="Hereditary diffuse gastric cancer">hereditary diffuse gastric cancer</a> (HDGC). The <i>CDH1</i> gene, which codes for E-cadherin, lies on the 16th chromosome.<sup id="cite_ref-chel_48-0" class="reference"><a href="#cite_note-chel-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> When the gene experiences a particular mutation, gastric cancer develops through a mechanism that is not fully understood.<sup id="cite_ref-chel_48-1" class="reference"><a href="#cite_note-chel-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup> This mutation is considered autosomal dominant, meaning that half of a carrier's children will likely experience the same mutation.<sup id="cite_ref-chel_48-2" class="reference"><a href="#cite_note-chel-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> Diagnosis of hereditary diffuse gastric cancer usually takes place when at least two cases involving a family member, such as a parent or grandparent, are diagnosed, with at least one diagnosed before the age of 50.<sup id="cite_ref-chel_48-3" class="reference"><a href="#cite_note-chel-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> The diagnosis can also be made if at least three cases occur in the family, in which case age is not considered.<sup id="cite_ref-chel_48-4" class="reference"><a href="#cite_note-chel-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> </p><p>The <a href="/wiki/International_Cancer_Genome_Consortium" title="International Cancer Genome Consortium">International Cancer Genome Consortium</a> is leading efforts to identify <a href="/wiki/Genome" title="Genome">genomic</a> changes involved in stomach cancer.<sup id="cite_ref-ICGC-USA_50-0" class="reference"><a href="#cite_note-ICGC-USA-50"><span class="cite-bracket">&#91;</span>50<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-ICGC-China_51-0" class="reference"><a href="#cite_note-ICGC-China-51"><span class="cite-bracket">&#91;</span>51<span class="cite-bracket">&#93;</span></a></sup> A very small percentage of diffuse-type gastric cancers (see Histopathology below) arise from an <a href="/wiki/Heredity" title="Heredity">inherited</a> abnormal <i><a href="/wiki/CDH1_(gene)" class="mw-redirect" title="CDH1 (gene)">CDH1</a></i> <a href="/wiki/Gene" title="Gene">gene</a>. <a href="/wiki/Genetic_testing" title="Genetic testing">Genetic testing</a> and treatment options are available for families at risk.<sup id="cite_ref-pmid15235021_52-0" class="reference"><a href="#cite_note-pmid15235021-52"><span class="cite-bracket">&#91;</span>52<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=8" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>To find the cause of symptoms, the doctor asks about the patient's medical history, does a physical examination, and may order laboratory studies.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">&#91;</span>53<span class="cite-bracket">&#93;</span></a></sup> The patient may also have one or all of these exams: </p> <ul><li><a href="/wiki/Gastroscopic_exam" class="mw-redirect" title="Gastroscopic exam">Gastroscopic exam</a> is the diagnostic method of choice. This involves insertion of a <a href="/wiki/Fibre_optic" class="mw-redirect" title="Fibre optic">fibre optic</a> camera into the stomach to visualise it.<sup id="cite_ref-pmid24191271_37-1" class="reference"><a href="#cite_note-pmid24191271-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Upper_GI_series" class="mw-redirect" title="Upper GI series">Upper GI series</a> (may be called barium roentgenogram)</li> <li><a href="/wiki/Computed_tomography" class="mw-redirect" title="Computed tomography">Computed tomography</a> or CT scanning of the abdomen may reveal gastric cancer. It is more useful to determine invasion into adjacent tissues or the presence of spread to local lymph nodes. Wall thickening of more than 1&#160;cm that is focal, eccentric, and enhancing favours malignancy.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">&#91;</span>54<span class="cite-bracket">&#93;</span></a></sup></li></ul> <p>In 2013, Chinese and Israeli scientists reported a successful <a href="/wiki/Pilot_study" class="mw-redirect" title="Pilot study">pilot study</a> of a <a href="/wiki/Breathalyzer" title="Breathalyzer">breathalyzer</a>-style breath test intended to diagnose stomach cancer by analyzing exhaled chemicals without the need for an intrusive <a href="/wiki/Endoscopy" title="Endoscopy">endoscopy</a>.<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> A larger-scale <a href="/wiki/Clinical_trial" title="Clinical trial">clinical trial</a> of this technology was completed in 2014.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">&#91;</span>57<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-58" class="reference"><a href="#cite_note-58"><span class="cite-bracket">&#91;</span>58<span class="cite-bracket">&#93;</span></a></sup> </p><p>Abnormal tissue seen in a gastroscope examination is <a href="/wiki/Biopsy" title="Biopsy">biopsied</a> by the <a href="/wiki/Surgery" title="Surgery">surgeon</a> or <a href="/wiki/Gastroenterologist" class="mw-redirect" title="Gastroenterologist">gastroenterologist</a>. This tissue is then sent to a <a href="/wiki/Pathology" title="Pathology">pathologist</a> for <a href="/wiki/Histology" title="Histology">histological</a> examination under a microscope to check for the presence of cancerous cells. A biopsy, with subsequent histological analysis, is the only sure way to confirm the presence of cancer cells.<sup id="cite_ref-pmid24191271_37-2" class="reference"><a href="#cite_note-pmid24191271-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup> </p><p>Various gastroscopic modalities have been developed to increase yield of detected mucosa with a dye that accentuates the cell structure and can identify areas of dysplasia. Endocytoscopy involves ultra-high magnification to visualise cellular structure to better determine areas of dysplasia. Other gastroscopic modalities such as <a href="/wiki/Optical_coherence_tomography" title="Optical coherence tomography">optical coherence tomography</a> are being tested investigationally for similar applications.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> </p><p>A number of <a href="/wiki/Cutaneous_condition" class="mw-redirect" title="Cutaneous condition">cutaneous conditions</a> are associated with gastric cancer. A condition of darkened <a href="/wiki/Hyperplasia" title="Hyperplasia">hyperplasia</a> of the skin, frequently of the <a href="/wiki/Axilla" title="Axilla">axilla</a> and groin, known as <a href="/wiki/Acanthosis_nigricans" title="Acanthosis nigricans">acanthosis nigricans</a>, is associated with intra-abdominal cancers such as gastric cancer. Other cutaneous manifestations of gastric cancer include "tripe palms" (a similar darkening hyperplasia of the skin of the palms) and the <a href="/wiki/Leser-Trelat_sign" class="mw-redirect" title="Leser-Trelat sign">Leser-Trelat sign</a>, which is the rapid development of skin lesions known as <a href="/wiki/Seborrheic_keratosis" title="Seborrheic keratosis">seborrheic keratoses</a>.<sup id="cite_ref-pmid15230897_60-0" class="reference"><a href="#cite_note-pmid15230897-60"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup> </p><p>Various blood tests may be done, including a <a href="/wiki/Complete_Blood_Count" class="mw-redirect" title="Complete Blood Count">complete blood count</a> to check for anaemia, and a <a href="/wiki/Fecal_occult_blood" title="Fecal occult blood">fecal occult blood test</a> to check for blood in the stool.<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">&#91;</span>61<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Histopathology">Histopathology</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=9" title="Edit section: Histopathology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Pie_chart_of_stomach_cancer_types_by_relative_incidence.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Pie_chart_of_stomach_cancer_types_by_relative_incidence.png/220px-Pie_chart_of_stomach_cancer_types_by_relative_incidence.png" decoding="async" width="220" height="195" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Pie_chart_of_stomach_cancer_types_by_relative_incidence.png/330px-Pie_chart_of_stomach_cancer_types_by_relative_incidence.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Pie_chart_of_stomach_cancer_types_by_relative_incidence.png/440px-Pie_chart_of_stomach_cancer_types_by_relative_incidence.png 2x" data-file-width="733" data-file-height="649" /></a><figcaption>Stomach cancer types by relative incidence<sup id="cite_ref-62" class="reference"><a href="#cite_note-62"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup></figcaption></figure> <ul><li><i>Gastric <a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">adenocarcinoma</a></i> is a malignant epithelial tumour, originating from glandular epithelium of the gastric mucosa. Stomach cancers are about 90% <a href="/wiki/Adenocarcinomas" class="mw-redirect" title="Adenocarcinomas">adenocarcinomas</a>.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup> Histologically, there are two major types of gastric adenocarcinoma (<a href="/w/index.php?title=Lauren_classification&amp;action=edit&amp;redlink=1" class="new" title="Lauren classification (page does not exist)">Lauren classification</a>): intestinal type or diffuse type. Adenocarcinomas tend to aggressively invade the gastric wall, infiltrating the <a href="/wiki/Muscularis_mucosae" title="Muscularis mucosae">muscularis mucosae</a>, the <a href="/wiki/Submucosa" title="Submucosa">submucosa</a> and then the <a href="/wiki/Muscularis_propria" class="mw-redirect" title="Muscularis propria">muscularis propria</a>. Intestinal type adenocarcinoma tumour cells describe irregular tubular structures, harbouring pluristratification, multiple lumens, reduced stroma ("back to back" aspect). Often, it associates intestinal metaplasia in neighbouring mucosa. Depending on glandular architecture, cellular pleomorphism and mucosecretion, adenocarcinoma may present 3 degrees of differentiation: well, moderate and poorly differentiated. <a href="/wiki/Linitis_plastica" title="Linitis plastica">Diffuse type</a> adenocarcinoma (mucinous, colloid, <a href="/wiki/Linitis_plastica" title="Linitis plastica">linitis plastica</a> or leather-bottle stomach) tumour cells are discohesive and secrete mucus, which is delivered in the interstitium, producing large pools of mucus/colloid (optically "empty" spaces). It is poorly differentiated. In <a href="/wiki/Signet_ring_cell_carcinoma" title="Signet ring cell carcinoma">signet ring cell carcinomas</a>, the mucus remains inside the tumour cell and pushes the nucleus to the periphery, giving rise to <a href="/wiki/Signet-ring_cell" class="mw-redirect" title="Signet-ring cell">signet-ring cells</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup></li> <li>Around 5% of gastric cancers are lymphomas.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">&#91;</span>64<span class="cite-bracket">&#93;</span></a></sup> These may include <a href="/wiki/Marginal_zone_B-cell_lymphoma#Extranodal_marginal_zone_lymphoma" class="mw-redirect" title="Marginal zone B-cell lymphoma">extranodal marginal zone B-cell lymphomas</a> (MALT type)<sup id="cite_ref-Bur2017_65-0" class="reference"><a href="#cite_note-Bur2017-65"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup> and to a lesser extent <a href="/wiki/Diffuse_large_B-cell_lymphoma" title="Diffuse large B-cell lymphoma">diffuse large B-cell lymphomas</a>.<sup id="cite_ref-pmid25052386_66-0" class="reference"><a href="#cite_note-pmid25052386-66"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup> MALT type make up about half of stomach lymphomas.<sup id="cite_ref-St2010_15-1" class="reference"><a href="#cite_note-St2010-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup></li> <li><a href="/wiki/Carcinoid" title="Carcinoid">Carcinoid</a> and stromal tumors may occur.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup></li></ul> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 170px;"><span typeof="mw:File"><a href="/wiki/File:Adenocarcinoma_low_differentiated_(stomach)_H%26E_magn_400x.jpg" class="mw-file-description" title="Poor to moderately differentiated adenocarcinoma of the stomach. H&amp;E stain."><img alt="Poor to moderately differentiated adenocarcinoma of the stomach. H&amp;E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/8/85/Adenocarcinoma_low_differentiated_%28stomach%29_H%26E_magn_400x.jpg/175px-Adenocarcinoma_low_differentiated_%28stomach%29_H%26E_magn_400x.jpg" decoding="async" width="175" height="140" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/85/Adenocarcinoma_low_differentiated_%28stomach%29_H%26E_magn_400x.jpg/263px-Adenocarcinoma_low_differentiated_%28stomach%29_H%26E_magn_400x.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/85/Adenocarcinoma_low_differentiated_%28stomach%29_H%26E_magn_400x.jpg/350px-Adenocarcinoma_low_differentiated_%28stomach%29_H%26E_magn_400x.jpg 2x" data-file-width="1280" data-file-height="1024" /></a></span></div> <div class="gallerytext">Poor to moderately differentiated adenocarcinoma of the stomach. <a href="/wiki/H%26E_stain" title="H&amp;E stain">H&amp;E stain</a>.</div> </li> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 170px;"><span typeof="mw:File"><a href="/wiki/File:Gastric_signet_ring_cell_carcinoma_histopatholgy_(1).jpg" class="mw-file-description" title="Gastric signet ring cell carcinoma. H&amp;E stain."><img alt="Gastric signet ring cell carcinoma. H&amp;E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/1/11/Gastric_signet_ring_cell_carcinoma_histopatholgy_%281%29.jpg/180px-Gastric_signet_ring_cell_carcinoma_histopatholgy_%281%29.jpg" decoding="async" width="180" height="135" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/11/Gastric_signet_ring_cell_carcinoma_histopatholgy_%281%29.jpg/270px-Gastric_signet_ring_cell_carcinoma_histopatholgy_%281%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/11/Gastric_signet_ring_cell_carcinoma_histopatholgy_%281%29.jpg/360px-Gastric_signet_ring_cell_carcinoma_histopatholgy_%281%29.jpg 2x" data-file-width="500" data-file-height="376" /></a></span></div> <div class="gallerytext">Gastric <a href="/wiki/Signet_ring_cell_carcinoma" title="Signet ring cell carcinoma">signet ring cell carcinoma</a>. <a href="/wiki/H%26E_stain" title="H&amp;E stain">H&amp;E stain</a>.</div> </li> <li class="gallerybox" style="width: 215px"> <div class="thumb" style="width: 210px; height: 170px;"><span typeof="mw:File"><a href="/wiki/File:Gastric_adenocarcinoma.jpg" class="mw-file-description" title="Adenocarcinoma of the stomach and intestinal metaplasia. H&amp;E stain."><img alt="Adenocarcinoma of the stomach and intestinal metaplasia. H&amp;E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/5/56/Gastric_adenocarcinoma.jpg/180px-Gastric_adenocarcinoma.jpg" decoding="async" width="180" height="135" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/56/Gastric_adenocarcinoma.jpg/270px-Gastric_adenocarcinoma.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/56/Gastric_adenocarcinoma.jpg/360px-Gastric_adenocarcinoma.jpg 2x" data-file-width="2048" data-file-height="1536" /></a></span></div> <div class="gallerytext">Adenocarcinoma of the stomach and <a href="/wiki/Intestinal_metaplasia" title="Intestinal metaplasia">intestinal metaplasia</a>. <a href="/wiki/H%26E_stain" title="H&amp;E stain">H&amp;E stain</a>.</div> </li> </ul> <div class="mw-heading mw-heading3"><h3 id="Staging">Staging</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=10" title="Edit section: Staging"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Diagram_showing_the_T_stages_of_stomach_cancer_CRUK_374.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/08/Diagram_showing_the_T_stages_of_stomach_cancer_CRUK_374.svg/220px-Diagram_showing_the_T_stages_of_stomach_cancer_CRUK_374.svg.png" decoding="async" width="220" height="276" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/08/Diagram_showing_the_T_stages_of_stomach_cancer_CRUK_374.svg/330px-Diagram_showing_the_T_stages_of_stomach_cancer_CRUK_374.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/08/Diagram_showing_the_T_stages_of_stomach_cancer_CRUK_374.svg/440px-Diagram_showing_the_T_stages_of_stomach_cancer_CRUK_374.svg.png 2x" data-file-width="375" data-file-height="470" /></a><figcaption>T stages of stomach cancer</figcaption></figure> <p>If cancer cells are found in the tissue sample, the next step is to <a href="/wiki/Cancer_staging" title="Cancer staging">stage</a>, or find out the extent of the disease. Various tests determine whether the cancer has spread, and if so, what parts of the body are affected. Because stomach cancer can spread to the liver, pancreas, and other organs near the stomach, as well as to the lungs, the doctor may order a <a href="/wiki/CT_scan" title="CT scan">CT scan</a>, a <a href="/wiki/PET_scan" class="mw-redirect" title="PET scan">PET scan</a>,<sup id="cite_ref-pmid16418249_67-0" class="reference"><a href="#cite_note-pmid16418249-67"><span class="cite-bracket">&#91;</span>67<span class="cite-bracket">&#93;</span></a></sup> an <a href="/wiki/Endoscopic_ultrasound" title="Endoscopic ultrasound">endoscopic ultrasound</a> exam, or other tests to check these areas. Blood tests for <a href="/wiki/Tumor_marker" title="Tumor marker">tumor markers</a>, such as <a href="/wiki/Carcinoembryonic_antigen" title="Carcinoembryonic antigen">carcinoembryonic antigen</a> and carbohydrate antigen may be ordered, as their levels correlate to extent of metastasis, especially to the liver, and the cure rate.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p><p>Staging may not be complete until after surgery. The surgeon removes nearby lymph nodes and possibly samples of tissue from other areas in the abdomen for examination by a pathologist.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p><p>The clinical stages of stomach cancer are:<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">&#91;</span>68<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-69" class="reference"><a href="#cite_note-69"><span class="cite-bracket">&#91;</span>69<span class="cite-bracket">&#93;</span></a></sup> </p> <ul><li><b>Stage 0</b> – Limited to the inner lining of the stomach, it is treatable by endoscopic mucosal resection when found very early (in routine screenings), or otherwise by <a href="/wiki/Gastrectomy" title="Gastrectomy">gastrectomy</a> and <a href="/wiki/Lymphadenectomy" title="Lymphadenectomy">lymphadenectomy</a> without need for chemotherapy or radiation.</li> <li><b>Stage I</b> – Penetration to the second or third layers of the stomach (stage 1A) or to the second layer and nearby <a href="/wiki/Lymph_nodes" class="mw-redirect" title="Lymph nodes">lymph nodes</a> (stage 1B): Stage 1A is treated by surgery, including removal of the <a href="/wiki/Greater_omentum" title="Greater omentum">omentum</a>. Stage 1B may be treated with chemotherapy (<a href="/wiki/5-fluorouracil" class="mw-redirect" title="5-fluorouracil">5-fluorouracil</a>) and radiation therapy.</li> <li><b>Stage II</b> – Penetration to the second layer and more distant lymph nodes, or the third layer and only nearby lymph nodes, or all four layers but not the lymph nodes, it is treated as for stage I, sometimes with additional <a href="/wiki/Adjuvant_chemotherapy#Neoadjuvant_therapy" class="mw-redirect" title="Adjuvant chemotherapy">neoadjuvant chemotherapy</a>.</li> <li><b>Stage III</b> – Penetration to the third layer and more distant lymph nodes, or penetration to the fourth layer and either nearby tissues or nearby or more distant lymph nodes, it is treated as for stage II; a cure is still possible in some cases.</li> <li><b>Stage IV</b> – Cancer has spread to nearby tissues and more distant lymph nodes, or has <a href="/wiki/Metastasize" class="mw-redirect" title="Metastasize">metastasized</a> to other organs. A cure is very rarely possible at this stage. Some other techniques to prolong life or improve symptoms are used, including laser treatment, surgery, and/or stents to keep the digestive tract open, and chemotherapy by drugs such as 5-fluorouracil, <a href="/wiki/Cisplatin" title="Cisplatin">cisplatin</a>, <a href="/wiki/Epirubicin" title="Epirubicin">epirubicin</a>, <a href="/wiki/Etoposide" title="Etoposide">etoposide</a>, <a href="/wiki/Docetaxel" title="Docetaxel">docetaxel</a>, <a href="/wiki/Oxaliplatin" title="Oxaliplatin">oxaliplatin</a>, <a href="/wiki/Capecitabine" title="Capecitabine">capecitabine</a>, or <a href="/wiki/Irinotecan" title="Irinotecan">irinotecan</a>.<sup id="cite_ref-Wagner17_13-1" class="reference"><a href="#cite_note-Wagner17-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup></li></ul> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Diagram_showing_secondary_stomach_cancer_in_the_lungs_CRUK_186.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/Diagram_showing_secondary_stomach_cancer_in_the_lungs_CRUK_186.svg/220px-Diagram_showing_secondary_stomach_cancer_in_the_lungs_CRUK_186.svg.png" decoding="async" width="220" height="156" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/Diagram_showing_secondary_stomach_cancer_in_the_lungs_CRUK_186.svg/330px-Diagram_showing_secondary_stomach_cancer_in_the_lungs_CRUK_186.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/83/Diagram_showing_secondary_stomach_cancer_in_the_lungs_CRUK_186.svg/440px-Diagram_showing_secondary_stomach_cancer_in_the_lungs_CRUK_186.svg.png 2x" data-file-width="375" data-file-height="266" /></a><figcaption>Stomach cancer metastasized to the lungs</figcaption></figure> <p>The <a href="/wiki/TNM_staging_system" title="TNM staging system">TNM staging system</a> is also used.<sup id="cite_ref-70" class="reference"><a href="#cite_note-70"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> </p><p>In a study of open-access endoscopy in <a href="/wiki/Scotland" title="Scotland">Scotland</a>, patients were diagnosed 7% in stage I, 17% in stage II, and 28% in stage III.<sup id="cite_ref-71" class="reference"><a href="#cite_note-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> A Minnesota population was diagnosed 10% in stage I, 13% in stage II, and 18% in stage III.<sup id="cite_ref-72" class="reference"><a href="#cite_note-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> However, in a high-risk population in the <a href="/wiki/Valdivia_Province" title="Valdivia Province">Valdivia Province</a> of southern <a href="/wiki/Chile" title="Chile">Chile</a>, only 5% of patients were diagnosed in the first two stages and 10% in stage III.<sup id="cite_ref-Valdivia_73-0" class="reference"><a href="#cite_note-Valdivia-73"><span class="cite-bracket">&#91;</span>73<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=11" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Getting rid of <i>H. pylori</i> in those who are infected decreases the risk of stomach cancer.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">&#91;</span>74<span class="cite-bracket">&#93;</span></a></sup> A 2014 meta-analysis of observational studies found that a diet high in <a href="/wiki/Fruit" title="Fruit">fruits</a>, <a href="/wiki/Edible_mushroom" title="Edible mushroom">mushrooms</a>, <a href="/wiki/Garlic" title="Garlic">garlic</a>, <a href="/wiki/Soybean" title="Soybean">soybeans</a>, and <a href="/wiki/Green_onion" class="mw-redirect" title="Green onion">green onions</a> was associated with a lower risk of stomach cancer in the Korean population.<sup id="cite_ref-Woo2014_75-0" class="reference"><a href="#cite_note-Woo2014-75"><span class="cite-bracket">&#91;</span>75<span class="cite-bracket">&#93;</span></a></sup> Low doses of <a href="/wiki/Vitamin" title="Vitamin">vitamins</a>, especially from a <a href="/wiki/Healthy_diet" title="Healthy diet">healthy diet</a>, decrease the risk of stomach cancer.<sup id="cite_ref-76" class="reference"><a href="#cite_note-76"><span class="cite-bracket">&#91;</span>76<span class="cite-bracket">&#93;</span></a></sup> A previous review of <a href="/wiki/Antioxidant" title="Antioxidant">antioxidant</a> supplementation did not find supporting evidence and possibly worse outcomes.<sup id="cite_ref-77" class="reference"><a href="#cite_note-77"><span class="cite-bracket">&#91;</span>77<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-78" class="reference"><a href="#cite_note-78"><span class="cite-bracket">&#91;</span>78<span class="cite-bracket">&#93;</span></a></sup> Modern technology is used to promote early diagnosis, e.g. based on serum markers.<sup id="cite_ref-79" class="reference"><a href="#cite_note-79"><span class="cite-bracket">&#91;</span>79<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=12" title="Edit section: Management"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Cancer of the stomach is difficult to cure unless it is found at an early stage (before it has begun to spread). Unfortunately, because early stomach cancer causes few symptoms, the disease is usually advanced when the diagnosis is made.<sup id="cite_ref-pmid23639645_80-0" class="reference"><a href="#cite_note-pmid23639645-80"><span class="cite-bracket">&#91;</span>80<span class="cite-bracket">&#93;</span></a></sup> </p><p>Treatment for stomach cancer may include surgery,<sup id="cite_ref-pmid23983442_81-0" class="reference"><a href="#cite_note-pmid23983442-81"><span class="cite-bracket">&#91;</span>81<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>,<sup id="cite_ref-Wagner17_13-2" class="reference"><a href="#cite_note-Wagner17-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> or <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a>.<sup id="cite_ref-pmid23622077_82-0" class="reference"><a href="#cite_note-pmid23622077-82"><span class="cite-bracket">&#91;</span>82<span class="cite-bracket">&#93;</span></a></sup> New treatment approaches such as <a href="/wiki/Immunotherapy" title="Immunotherapy">immunotherapy</a> or <a href="/wiki/Gene_therapy" title="Gene therapy">gene therapy</a> and improved ways of using current methods are being studied in clinical trials.<sup id="cite_ref-pmid21556317_83-0" class="reference"><a href="#cite_note-pmid21556317-83"><span class="cite-bracket">&#91;</span>83<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=13" title="Edit section: Surgery"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Diagam_showing_the_anatomy_before_Roux-en-y_surgery_for_stomach_cancer_CRUK_002.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f5/Diagam_showing_the_anatomy_before_Roux-en-y_surgery_for_stomach_cancer_CRUK_002.svg/220px-Diagam_showing_the_anatomy_before_Roux-en-y_surgery_for_stomach_cancer_CRUK_002.svg.png" decoding="async" width="220" height="197" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f5/Diagam_showing_the_anatomy_before_Roux-en-y_surgery_for_stomach_cancer_CRUK_002.svg/330px-Diagam_showing_the_anatomy_before_Roux-en-y_surgery_for_stomach_cancer_CRUK_002.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f5/Diagam_showing_the_anatomy_before_Roux-en-y_surgery_for_stomach_cancer_CRUK_002.svg/440px-Diagam_showing_the_anatomy_before_Roux-en-y_surgery_for_stomach_cancer_CRUK_002.svg.png 2x" data-file-width="375" data-file-height="335" /></a><figcaption>Anatomy before Roux-en-y surgery to resect stomach cancer</figcaption></figure> <p>Surgery remains the only curative therapy for stomach cancer.<sup id="cite_ref-WJG14_6-3" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> A 2016 <a href="/wiki/Cochrane_review" class="mw-redirect" title="Cochrane review">Cochrane review</a> found low-quality evidence of no difference in short-term mortality between laparoscopic and open gastrectomy (removal of stomach), and that benefits or harms of laparoscopic gastrectomy cannot be ruled out.<sup id="cite_ref-84" class="reference"><a href="#cite_note-84"><span class="cite-bracket">&#91;</span>84<span class="cite-bracket">&#93;</span></a></sup> Post-operatively, up to 70% of people undergoing total gastrectomy develop complications such as dumping syndrome and reflux esophagitis.<sup id="cite_ref-:0_85-0" class="reference"><a href="#cite_note-:0-85"><span class="cite-bracket">&#91;</span>85<span class="cite-bracket">&#93;</span></a></sup> Construction of a "pouch", which serves as a "stomach substitute", reduced the incidence of dumping syndrome and reflux esophagitis by 73% and 63% respectively, and led to improvements in quality-of-life, nutritional outcomes, and body mass index.<sup id="cite_ref-:0_85-1" class="reference"><a href="#cite_note-:0-85"><span class="cite-bracket">&#91;</span>85<span class="cite-bracket">&#93;</span></a></sup> Proximal gastrectomy (PG) can be considered a viable alternative for upper third early gastric cancer (EGC)<sup id="cite_ref-Narayan2024_86-0" class="reference"><a href="#cite_note-Narayan2024-86"><span class="cite-bracket">&#91;</span>86<span class="cite-bracket">&#93;</span></a></sup> Of the different surgical techniques, <a href="/wiki/Endoscopic_mucosal_resection" title="Endoscopic mucosal resection">endoscopic mucosal resection</a> (EMR) is a treatment for early gastric cancer (tumor only involves the <a href="/wiki/Mucosa" class="mw-redirect" title="Mucosa">mucosa</a>) that was pioneered in Japan and is available in the United States at some centers.<sup id="cite_ref-WJG14_6-4" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> In EMR, the tumor, together with the inner lining of stomach (mucosa), is removed from the wall of the stomach using an electrical wire loop through the endoscope. The advantage is that it is a much smaller operation than removing the stomach.<sup id="cite_ref-WJG14_6-5" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Endoscopy" title="Endoscopy">Endoscopic submucosal dissection</a> is a similar technique pioneered in Japan, used to resect a large area of mucosa in one piece.<sup id="cite_ref-WJG14_6-6" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> If the pathologic examination of the resected specimen shows incomplete resection or deep invasion by tumor, the patient would need a formal stomach resection.<sup id="cite_ref-WJG14_6-7" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> </p><p>Those with metastatic disease at the time of presentation may receive palliative surgery, and while it remains controversial, due to the possibility of complications from the surgery itself and because it may delay chemotherapy, the data so far are mostly positive, with improved survival rates being seen in those treated with this approach.<sup id="cite_ref-WJG14_6-8" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-87" class="reference"><a href="#cite_note-87"><span class="cite-bracket">&#91;</span>87<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Chemotherapy">Chemotherapy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=14" title="Edit section: Chemotherapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The use of chemotherapy to treat stomach cancer has no firmly established <a href="/wiki/Standard_of_care" title="Standard of care">standard of care</a>.<sup id="cite_ref-Wagner17_13-3" class="reference"><a href="#cite_note-Wagner17-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> Unfortunately, stomach cancer has not been particularly sensitive to these drugs, and chemotherapy, if used, has usually served to palliatively reduce the size of the tumor, relieve symptoms of the disease, and increase survival time.<sup id="cite_ref-Wagner17_13-4" class="reference"><a href="#cite_note-Wagner17-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> Some drugs used in stomach cancer treatment have included: fluorouracil or its analog <a href="/wiki/Capecitabine" title="Capecitabine">capecitabine</a>, BCNU (<a href="/wiki/Carmustine" title="Carmustine">carmustine</a>), methyl-CCNU (<a href="/wiki/Semustine" title="Semustine">semustine</a>) and <a href="/wiki/Doxorubicin" title="Doxorubicin">doxorubicin</a> (Adriamycin), as well as <a href="/wiki/Mitomycin_C" title="Mitomycin C">mitomycin C</a>, and more recently <a href="/wiki/Cisplatin" title="Cisplatin">cisplatin</a> and <a href="/wiki/Taxotere" class="mw-redirect" title="Taxotere">taxotere</a>, often using drugs in various combinations.<sup id="cite_ref-Wagner17_13-5" class="reference"><a href="#cite_note-Wagner17-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup> The relative benefits of these different drugs, alone and in combination, are unclear.<sup id="cite_ref-Wagner17_13-6" class="reference"><a href="#cite_note-Wagner17-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid17425475_88-0" class="reference"><a href="#cite_note-pmid17425475-88"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup> Clinical researchers are exploring the benefits of giving chemotherapy before surgery to shrink the tumor, or as adjuvant therapy after surgery to destroy remaining cancer cells.<sup id="cite_ref-WJG14_6-9" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Targeted_therapy">Targeted therapy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=15" title="Edit section: Targeted therapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Recently<sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items" title="Wikipedia:Manual of Style/Dates and numbers"><span title="The time period mentioned near this tag is ambiguous. (March 2022)">when?</span></a></i>&#93;</sup>, treatment with <a href="/wiki/HER2/neu" class="mw-redirect" title="HER2/neu">human epidermal growth factor receptor 2 (<i>HER2</i>)</a> inhibitor, <a href="/wiki/Trastuzumab" title="Trastuzumab">trastuzumab</a>, has been demonstrated to increase <a href="/wiki/Overall_survival_rate" class="mw-redirect" title="Overall survival rate">overall survival</a> in inoperable locally advanced or metastatic gastric carcinoma over-expressing the <i><a href="/wiki/HER2/neu" class="mw-redirect" title="HER2/neu">HER2/neu</a></i> gene.<sup id="cite_ref-WJG14_6-10" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> In particular, <i><a href="/wiki/HER2/neu" class="mw-redirect" title="HER2/neu">HER2</a></i> is overexpressed in 13–22% of patients with gastric cancer.<sup id="cite_ref-pmid21556317_83-1" class="reference"><a href="#cite_note-pmid21556317-83"><span class="cite-bracket">&#91;</span>83<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Fusco13_89-0" class="reference"><a href="#cite_note-Fusco13-89"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> Of note, <i>HER2</i> overexpression in gastric neoplasia is heterogeneous and comprises a minority of tumor cells (less than 10% of gastric cancers overexpress <i>HER2</i> in more than 5% of tumor cells). Hence, this heterogeneous expression should be taken into account for <i>HER2</i> testing, particularly in small samples such as biopsies, requiring the evaluation of more than one bioptic sample.<sup id="cite_ref-Fusco13_89-1" class="reference"><a href="#cite_note-Fusco13-89"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> </p><p>A recent clinical study reported promising results for a combination therapy using Nivolumab and Anlotinib in the treatment of advanced gastric adenocarcinoma (GAC) and esophageal squamous cell carcinoma (ESCC), that improve the immune response against cancer while simultaneously slowing tumor progression.<sup id="cite_ref-90" class="reference"><a href="#cite_note-90"><span class="cite-bracket">&#91;</span>90<span class="cite-bracket">&#93;</span></a></sup> The research, conducted by Zhongshan Hospital, Fudan University, and BGI Genomics, was published in <i>Nature Communications</i> in October 2024. The study evaluated the efficacy of combining Nivolumab, an immunotherapy that enhances the immune system's ability to attack cancer cells, with anlotinib hydrochloride, a drug that inhibits tumor angiogenesis by blocking signals essential for the growth of new blood vessels.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91"><span class="cite-bracket">&#91;</span>91<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Radiation">Radiation</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=16" title="Edit section: Radiation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Radiation_therapy" title="Radiation therapy">Radiation therapy</a> (also called radiotherapy) may be used to treat stomach cancer, often as an adjuvant to chemotherapy and/or surgery.<sup id="cite_ref-WJG14_6-11" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Lymphoma">Lymphoma</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=17" title="Edit section: Lymphoma"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/MALT_lymphoma" title="MALT lymphoma">MALT lymphomas</a> are often completely resolved after the underlying <i>H. pylori</i> infection is treated.<sup id="cite_ref-St2010_15-2" class="reference"><a href="#cite_note-St2010-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> This results in remission in about 80% of cases.<sup id="cite_ref-St2010_15-3" class="reference"><a href="#cite_note-St2010-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=18" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The prognosis of stomach cancer is generally poor, because the tumor has often metastasized by the time of discovery, and most people with the condition are elderly (median age is between 70 and 75 years) at presentation.<sup id="cite_ref-MSR_92-0" class="reference"><a href="#cite_note-MSR-92"><span class="cite-bracket">&#91;</span>92<span class="cite-bracket">&#93;</span></a></sup> The average life expectancy after being diagnosed is around 24 months, and the five-year survival rate for stomach cancer is less than 10%.<sup id="cite_ref-WJG14_6-12" class="reference"><a href="#cite_note-WJG14-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> </p><p>Almost 300 genes are related to outcomes in stomach cancer, with both unfavorable genes where high expression is related to poor survival and favorable genes where high expression is associated with longer survival times.<sup id="cite_ref-atlas_93-0" class="reference"><a href="#cite_note-atlas-93"><span class="cite-bracket">&#91;</span>93<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-94" class="reference"><a href="#cite_note-94"><span class="cite-bracket">&#91;</span>94<span class="cite-bracket">&#93;</span></a></sup> Examples of poor prognosis genes include <a href="/wiki/ITGAV" class="mw-redirect" title="ITGAV">ITGAV</a>, <a href="/wiki/DUSP1" title="DUSP1">DUSP1</a> and <a href="/wiki/P2RX7" title="P2RX7">P2RX7</a>.<sup id="cite_ref-95" class="reference"><a href="#cite_note-95"><span class="cite-bracket">&#91;</span>95<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=19" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Stomach_cancer_world_map-Deaths_per_million_persons-WHO2012.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Stomach_cancer_world_map-Deaths_per_million_persons-WHO2012.svg/280px-Stomach_cancer_world_map-Deaths_per_million_persons-WHO2012.svg.png" decoding="async" width="280" height="124" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Stomach_cancer_world_map-Deaths_per_million_persons-WHO2012.svg/420px-Stomach_cancer_world_map-Deaths_per_million_persons-WHO2012.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6d/Stomach_cancer_world_map-Deaths_per_million_persons-WHO2012.svg/560px-Stomach_cancer_world_map-Deaths_per_million_persons-WHO2012.svg.png 2x" data-file-width="940" data-file-height="415" /></a><figcaption>Stomach cancer deaths per million persons in 2012 <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col div-col-small" style="column-width: 10em;"><style data-mw-deduplicate="TemplateStyles:r981673959">.mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{}</style><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffff20; color:black;">&#160;</span>&#160;0–11</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffe820; color:black;">&#160;</span>&#160;12–16</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffd820; color:black;">&#160;</span>&#160;17–24</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffc020; color:black;">&#160;</span>&#160;25–33</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ffa020; color:black;">&#160;</span>&#160;34–51</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#ff9a20; color:black;">&#160;</span>&#160;52–76</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#f08015; color:black;">&#160;</span>&#160;77–102</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#e06815; color:black;">&#160;</span>&#160;103–128</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#d85010; color:black;">&#160;</span>&#160;129–175</div><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r981673959"><div class="legend"><span class="legend-color mw-no-invert" style="background-color:#d02010; color:white;">&#160;</span>&#160;176–400</div></div></figcaption></figure> <p>In 2018, stomach cancer was the fifth most frequently diagnosed cancer worldwide, representing 5.7% of all cancer cases, and the third leading cause of death from cancers, being responsible for 8.2% of all cancer deaths.<sup id="cite_ref-:1_96-0" class="reference"><a href="#cite_note-:1-96"><span class="cite-bracket">&#91;</span>96<span class="cite-bracket">&#93;</span></a></sup> Among men, 683 754 cases were diagnosed, accounting for 7.2% of all cancer cases, and among women, stomach cancer was diagnosed in 349 947 cases, accounting for 4.1% of all cancer cases.<sup id="cite_ref-:1_96-1" class="reference"><a href="#cite_note-:1-96"><span class="cite-bracket">&#91;</span>96<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 2012, stomach cancer was the fifth most-common cancer with 952,000 cases diagnosed.<sup id="cite_ref-WCR2014Epi_16-1" class="reference"><a href="#cite_note-WCR2014Epi-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> It is more common both in men and in developing countries.<sup id="cite_ref-Parkin_97-0" class="reference"><a href="#cite_note-Parkin-97"><span class="cite-bracket">&#91;</span>97<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-WHO-QA15_98-0" class="reference"><a href="#cite_note-WHO-QA15-98"><span class="cite-bracket">&#91;</span>98<span class="cite-bracket">&#93;</span></a></sup> In 2012, it represented 8.5% of cancer cases in men, making it the fourth most-common cancer in men.<sup id="cite_ref-99" class="reference"><a href="#cite_note-99"><span class="cite-bracket">&#91;</span>99<span class="cite-bracket">&#93;</span></a></sup> Also in 2012, the number of deaths was 700,000, having decreased slightly from 774,000 in 1990, making it the third-leading cause of cancer-related death (after <a href="/wiki/Lung_cancer" title="Lung cancer">lung cancer</a> and <a href="/wiki/Liver_cancer" title="Liver cancer">liver cancer</a>).<sup id="cite_ref-Loz2012_100-0" class="reference"><a href="#cite_note-Loz2012-100"><span class="cite-bracket">&#91;</span>100<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-101" class="reference"><a href="#cite_note-101"><span class="cite-bracket">&#91;</span>101<span class="cite-bracket">&#93;</span></a></sup> </p><p>Less than 5% of stomach cancers occur in people under 40 years of age, with 81.1% of that 5% in the age-group of 30 to 39 and 18.9% in the age-group of 20 to 29.<sup id="cite_ref-102" class="reference"><a href="#cite_note-102"><span class="cite-bracket">&#91;</span>102<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 2014, stomach cancer resulted in 0.61% of deaths (13,303 cases) in the United States.<sup id="cite_ref-103" class="reference"><a href="#cite_note-103"><span class="cite-bracket">&#91;</span>103<span class="cite-bracket">&#93;</span></a></sup> In China, stomach cancer accounted for 3.56% of all deaths (324,439 cases).<sup id="cite_ref-104" class="reference"><a href="#cite_note-104"><span class="cite-bracket">&#91;</span>104<span class="cite-bracket">&#93;</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Reliable_sources" title="Wikipedia:Reliable sources"><span title="The material near this tag may rely on an unreliable source. (November 2021)">unreliable source?</span></a></i>&#93;</sup> The highest rate of stomach cancer was in <a href="/wiki/Mongolia" title="Mongolia">Mongolia</a>, at 28 cases per 100,000 people.<sup id="cite_ref-105" class="reference"><a href="#cite_note-105"><span class="cite-bracket">&#91;</span>105<span class="cite-bracket">&#93;</span></a></sup><sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Reliable_sources" title="Wikipedia:Reliable sources"><span title="The material near this tag may rely on an unreliable source. (November 2021)">unreliable source?</span></a></i>&#93;</sup> </p><p>In the United Kingdom, stomach cancer is the 15th most-common cancer (around 7,100 people were diagnosed with stomach cancer in 2011), and it is the 10th most-common cause of cancer-related deaths (around 4,800 people died in 2012).<sup id="cite_ref-106" class="reference"><a href="#cite_note-106"><span class="cite-bracket">&#91;</span>106<span class="cite-bracket">&#93;</span></a></sup> </p><p>Incidence and mortality rates of gastric cancer vary greatly in Africa. The GLOBOCAN system is currently the most widely used method to compare these rates between countries, but African incidence and mortality rates are seen to differ among countries, possibly due to the lack of universal access to a registry system for all countries.<sup id="cite_ref-asom_107-0" class="reference"><a href="#cite_note-asom-107"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup> Variation as drastic as estimated rates from 0.3/100000 in Botswana to 20.3/100000 in Mali have been observed.<sup id="cite_ref-asom_107-1" class="reference"><a href="#cite_note-asom-107"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup> In Uganda, the incidence of gastric cancer has increased from the 1960s measurement of 0.8/100000 to 5.6/100000.<sup id="cite_ref-asom_107-2" class="reference"><a href="#cite_note-asom-107"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup> Gastric cancer, though present, is relatively low when compared to countries with high incidence like Japan and China. One suspected cause of the variation within Africa and between other countries is due to different strains of the <i>H. pylori</i> bacteria. The trend commonly seen is that <i>H. pylori </i>infection increases the risk for gastric cancer, but this is not the case in Africa, giving this phenomenon the name the "African enigma".<sup id="cite_ref-louw_108-0" class="reference"><a href="#cite_note-louw-108"><span class="cite-bracket">&#91;</span>108<span class="cite-bracket">&#93;</span></a></sup> Although this bacterial species is found in Africa, evidence has supported that different strains with mutations in the bacterial genotype may contribute to the difference in cancer development between African countries and others outside the continent.<sup id="cite_ref-louw_108-1" class="reference"><a href="#cite_note-louw-108"><span class="cite-bracket">&#91;</span>108<span class="cite-bracket">&#93;</span></a></sup> Increasing access to health care and treatment measures have been commonly associated with the rising incidence, though, particularly in Uganda.<sup id="cite_ref-asom_107-3" class="reference"><a href="#cite_note-asom-107"><span class="cite-bracket">&#91;</span>107<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Other_animals">Other animals</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=20" title="Edit section: Other animals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The stomach is a muscular organ of the <a href="/wiki/Gastrointestinal" class="mw-redirect" title="Gastrointestinal">gastrointestinal</a> tract that holds food and begins the digestive process by secreting gastric juice. The most common cancers of the stomach are adenocarcinomas, but other histological types have been reported. Signs vary, but may include vomiting (especially if blood is present), weight loss, anemia, and lack of appetite. Bowel movements may be dark and tarry in nature. To determine whether cancer is present in the stomach, special X-rays and/or abdominal ultrasounds may be performed. <a href="/wiki/Gastroscopy" class="mw-redirect" title="Gastroscopy">Gastroscopy</a>, a test using an endoscope to examine the stomach, is a useful diagnostic tool that can also take samples of the suspected mass for histopathological analysis to confirm or rule out cancer. The most definitive method of cancer diagnosis is through open surgical biopsy.<sup id="cite_ref-MacEwan_2013_109-0" class="reference"><a href="#cite_note-MacEwan_2013-109"><span class="cite-bracket">&#91;</span>109<span class="cite-bracket">&#93;</span></a></sup> Most stomach tumors are malignant with evidence of spread to lymph nodes or liver, making treatment difficult. Except for lymphoma, surgery is the most frequent treatment option for stomach cancers but it is associated with significant risks.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2021)">citation needed</span></a></i>&#93;</sup> </p><p>A <a href="/wiki/Carcinogenesis" title="Carcinogenesis">carcinogenic</a> interaction was demonstrated between <a href="/wiki/Bile_acid" title="Bile acid">bile acids</a> and <i><a href="/wiki/Helicobacter_pylori" title="Helicobacter pylori">Helicobacter pylori</a></i> in a mouse model of gastric cancer.<sup id="cite_ref-pmid35575088_110-0" class="reference"><a href="#cite_note-pmid35575088-110"><span class="cite-bracket">&#91;</span>110<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid35316215_111-0" class="reference"><a href="#cite_note-pmid35316215-111"><span class="cite-bracket">&#91;</span>111<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=21" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-NCI2014TxPt-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-NCI2014TxPt_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-NCI2014TxPt_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-NCI2014TxPt_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-NCI2014TxPt_1-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-NCI2014TxPt_1-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-NCI2014TxPt_1-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-NCI2014TxPt_1-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-NCI2014TxPt_1-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-NCI2014TxPt_1-8"><sup><i><b>i</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cancer.gov/cancertopics/pdq/treatment/gastric/Patient/page1/AllPages">"Gastric Cancer Treatment (PDQ®)"</a>. <i>NCI</i>. 17 April 2014. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20140705231337/http://www.cancer.gov/cancertopics/pdq/treatment/gastric/Patient/page1/AllPages">Archived</a> from the original on 5 July 2014<span class="reference-accessdate">. Retrieved <span class="nowrap">1 July</span> 2014</span>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=NCI&amp;rft.atitle=Gastric+Cancer+Treatment+%28PDQ%C2%AE%29&amp;rft.date=2014-04-17&amp;rft_id=http%3A%2F%2Fwww.cancer.gov%2Fcancertopics%2Fpdq%2Ftreatment%2Fgastric%2FPatient%2Fpage1%2FAllPages&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AStomach+cancer" class="Z3988"></span></span> </li> <li id="cite_note-WCR2014-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-WCR2014_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-WCR2014_2-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-WCR2014_2-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-WCR2014_2-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-WCR2014_2-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-WCR2014_2-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-WCR2014_2-6"><sup><i><b>g</b></i></sup></a> <a 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Oxford University Press. p.&#160;223. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-19-517543-1" title="Special:BookSources/978-0-19-517543-1"><bdi>978-0-19-517543-1</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150915231411/https://books.google.com/books?id=PymZ1ORk0TcC&amp;pg=PA223">Archived</a> from the original on 15 September 2015.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Cancer+biology&amp;rft.pages=223&amp;rft.edition=4th&amp;rft.pub=Oxford+University+Press&amp;rft.date=2007&amp;rft.isbn=978-0-19-517543-1&amp;rft.aulast=Ruddon&amp;rft.aufirst=RW&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DPymZ1ORk0TcC%26pg%3DPA223&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AStomach+cancer" class="Z3988"></span></span> </li> <li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSimMcKee2011" class="citation book cs1">Sim F, McKee M, eds. 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Wiley-Blackwell. p.&#160;259. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-1-4443-0637-8" title="Special:BookSources/978-1-4443-0637-8"><bdi>978-1-4443-0637-8</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Cancer+and+its+management&amp;rft.pages=259&amp;rft.edition=6th&amp;rft.pub=Wiley-Blackwell&amp;rft.date=2010&amp;rft.isbn=978-1-4443-0637-8&amp;rft.aulast=Tobias&amp;rft.aufirst=SJ&amp;rft.au=Hochhauser%2C+D&amp;rft.au=Souhami%2C+RL&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D9sW0eCoZFt4C%26pg%3DPA259&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AStomach+cancer" class="Z3988"></span></span> </li> <li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKhleifSkeel2011" class="citation book cs1">Khleif RT, Skeel SN, eds. 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Wolter Kluwer. p.&#160;127. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-1-60831-782-0" title="Special:BookSources/978-1-60831-782-0"><bdi>978-1-60831-782-0</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Handbook+of+cancer+chemotherapy&amp;rft.pages=127&amp;rft.edition=8th&amp;rft.pub=Wolter+Kluwer&amp;rft.date=2011&amp;rft.isbn=978-1-60831-782-0&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3D6Nz_87OLrtcC%26pg%3DPA127&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AStomach+cancer" class="Z3988"></span></span> </li> <li id="cite_note-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-20">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKnight2010" class="citation book cs1">Knight JA (2010). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=HBY_GxOY_6oC&amp;pg=PA339"><i>Human Longevity: The Major Determining Factors</i></a>. Author House. p.&#160;339. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-1-4520-6722-3" title="Special:BookSources/978-1-4520-6722-3"><bdi>978-1-4520-6722-3</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20150916003533/https://books.google.com/books?id=HBY_GxOY_6oC&amp;pg=PA339">Archived</a> from the original on 16 September 2015.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=book&amp;rft.btitle=Human+Longevity%3A+The+Major+Determining+Factors&amp;rft.pages=339&amp;rft.pub=Author+House&amp;rft.date=2010&amp;rft.isbn=978-1-4520-6722-3&amp;rft.aulast=Knight&amp;rft.aufirst=JA&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DHBY_GxOY_6oC%26pg%3DPA339&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AStomach+cancer" class="Z3988"></span><sup class="noprint Inline-Template" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Verifiability#Self-published_sources" title="Wikipedia:Verifiability"><span title="The material near this tag may rely on a self-published source. 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Elsevier. pp.&#160;402–3. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a>&#160;<a href="/wiki/Special:BookSources/978-0-323-24197-7" title="Special:BookSources/978-0-323-24197-7"><bdi>978-0-323-24197-7</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&amp;rft.genre=bookitem&amp;rft.atitle=22+Cancer+of+the+Gastrointestinal+tract+%C2%A7+E%3A+Gastric+Cancer%3A+Diagnostic+Techniques+and+Work-Up&amp;rft.btitle=Withrow+and+MacEwen%27s+Small+Animal+Clinical+Oncology&amp;rft.pages=402-3&amp;rft.edition=5th&amp;rft.pub=Elsevier&amp;rft.date=2013&amp;rft.isbn=978-0-323-24197-7&amp;rft.aulast=Withrow&amp;rft.aufirst=SJ&amp;rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DnYYlauGf0D4C%26pg%3DPA402&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AStomach+cancer" class="Z3988"></span></span> </li> <li id="cite_note-pmid35575088-110"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid35575088_110-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAlizadehRaufman2022" class="citation journal cs1">Alizadeh M, Raufman JP (May 2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106340">"Gastrointestinal neoplasia: carcinogenic interaction between bile acids and Helicobacter pylori in the stomach"</a>. <i>The Journal of Clinical Investigation</i>. <b>132</b> (10). <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1172%2FJCI160194">10.1172/JCI160194</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106340">9106340</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/35575088">35575088</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=The+Journal+of+Clinical+Investigation&amp;rft.atitle=Gastrointestinal+neoplasia%3A+carcinogenic+interaction+between+bile+acids+and+Helicobacter+pylori+in+the+stomach&amp;rft.volume=132&amp;rft.issue=10&amp;rft.date=2022-05&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9106340%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F35575088&amp;rft_id=info%3Adoi%2F10.1172%2FJCI160194&amp;rft.aulast=Alizadeh&amp;rft.aufirst=M&amp;rft.au=Raufman%2C+JP&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC9106340&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AStomach+cancer" class="Z3988"></span></span> </li> <li id="cite_note-pmid35316215-111"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid35316215_111-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNotoPiazueloShahRomero-Gallo2022" class="citation journal cs1">Noto JM, Piazuelo MB, Shah SC, Romero-Gallo J, Hart JL, Di C, et&#160;al. (May 2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106351">"Iron deficiency linked to altered bile acid metabolism promotes Helicobacter pylori-induced inflammation-driven gastric carcinogenesis"</a>. <i>The Journal of Clinical Investigation</i>. <b>132</b> (10). <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1172%2FJCI147822">10.1172/JCI147822</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9106351">9106351</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/35316215">35316215</a>.</cite><span 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class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Stomach_cancer&amp;action=edit&amp;section=22" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 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style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q189588" class="extiw" title="d:Q189588">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/C16">C16</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=151">151</a></li><li><b><a href="/wiki/Online_Mendelian_Inheritance_in_Man" title="Online Mendelian Inheritance in Man">OMIM</a></b>: <a rel="nofollow" class="external text" href="https://omim.org/entry/137215">137215</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D013274">D013274</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb12445.htm">12445</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000223.htm">000223</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/med/845-overview">med/845</a></li><li><b><a href="/wiki/National_Cancer_Institute" title="National Cancer Institute">NCI</a></b>: <a rel="nofollow" class="external text" href="https://www.cancer.gov/stomach">Stomach cancer</a></li></ul></div></div></td></tr></tbody></table></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid 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data-file-height="1376" /></span></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Stomach_cancer" class="extiw" title="commons:Category:Stomach cancer">Stomach cancer</a></span>.</div></div> </div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cancer.gov/types/stomach/hp/stomach-treatment-pdq#section/all">"Gastric cancer treatment guidelines"</a>. <i><a href="/wiki/National_Cancer_Institute" title="National Cancer Institute">National Cancer Institute</a></i>. 14 October 2022.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=unknown&amp;rft.jtitle=National+Cancer+Institute&amp;rft.atitle=Gastric+cancer+treatment+guidelines&amp;rft.date=2022-10-14&amp;rft_id=https%3A%2F%2Fwww.cancer.gov%2Ftypes%2Fstomach%2Fhp%2Fstomach-treatment-pdq%23section%2Fall&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AStomach+cancer" class="Z3988"></span></li></ul> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Digestive_system_neoplasia" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style 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neoplasm">Digestive system neoplasia</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Upper_alimentary_tract#Upper_gastrointestinal_tract" class="mw-redirect" title="Upper alimentary tract">Upper</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Esophageal_cancer" title="Esophageal cancer">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Squamous_cell_carcinoma" class="mw-redirect" title="Squamous cell carcinoma">Squamous cell carcinoma</a></li> <li><a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a class="mw-selflink selflink">Stomach</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastric_carcinoma" class="mw-redirect" title="Gastric carcinoma">Gastric carcinoma</a></li> <li><a href="/wiki/Signet_ring_cell_carcinoma" title="Signet ring cell carcinoma">Signet ring cell carcinoma</a></li> <li><a href="/wiki/Gastric_lymphoma" title="Gastric lymphoma">Gastric lymphoma</a> <ul><li><a href="/wiki/MALT_lymphoma" title="MALT lymphoma">MALT lymphoma</a></li></ul></li> <li><a href="/wiki/Linitis_plastica" title="Linitis plastica">Linitis plastica</a></li> <li><a href="/wiki/Hereditary_diffuse_gastric_cancer" title="Hereditary diffuse gastric cancer">Hereditary diffuse gastric cancer</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_gastrointestinal_tract#Lower_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">Lower</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine_cancer" title="Small intestine cancer">Small intestine</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Duodenal_cancer" title="Duodenal cancer">Duodenal cancer</a> <ul><li><a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Appendix_cancer" title="Appendix cancer">Appendix</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Carcinoid" title="Carcinoid">Carcinoid</a></li> <li><a href="/wiki/Pseudomyxoma_peritonei" title="Pseudomyxoma peritonei">Pseudomyxoma peritonei</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Colorectal_cancer" title="Colorectal cancer">Colon/rectum</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Colorectal_polyp" title="Colorectal polyp">Colorectal polyp</a>:</i> <a href="/wiki/Colorectal_adenoma" title="Colorectal adenoma">adenoma</a>, <a href="/wiki/Hyperplastic_polyp" title="Hyperplastic polyp">hyperplastic</a>, <a href="/wiki/Juvenile_polyp" title="Juvenile polyp">juvenile</a>, <a href="/wiki/Sessile_serrated_adenoma" class="mw-redirect" title="Sessile serrated adenoma">sessile serrated adenoma</a>, <a href="/wiki/Traditional_serrated_adenoma" title="Traditional serrated adenoma">traditional serrated adenoma</a>, <a href="/wiki/Peutz%E2%80%93Jeghers_syndrome" title="Peutz–Jeghers syndrome">Peutz–Jeghers</a>, <a href="/wiki/Cronkhite%E2%80%93Canada_syndrome" title="Cronkhite–Canada syndrome">Cronkhite–Canada</a></li></ul> <ul><li><i>Polyposis syndromes:</i> <a href="/wiki/Juvenile_polyposis_syndrome" title="Juvenile polyposis syndrome">Juvenile</a></li> <li><a href="/wiki/MUTYH-associated_polyposis" title="MUTYH-associated polyposis">MUTYH-associated</a></li> <li><a href="/wiki/Familial_adenomatous_polyposis" title="Familial adenomatous polyposis">Familial adenomatous</a>/<a href="/wiki/Gardner%27s_syndrome" title="Gardner&#39;s syndrome">Gardner's</a></li> <li><a href="/wiki/Polymerase_proofreading-associated_polyposis" title="Polymerase proofreading-associated polyposis">Polymerase proofreading-associated</a></li> <li><a href="/wiki/Serrated_polyposis_syndrome" title="Serrated polyposis syndrome">Serrated polyposis</a></li></ul> <ul><li><i>Neoplasm:</i> <a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a></li> <li><a href="/wiki/Familial_adenomatous_polyposis" title="Familial adenomatous polyposis">Familial adenomatous polyposis</a></li> <li><a href="/wiki/Hereditary_nonpolyposis_colorectal_cancer" title="Hereditary nonpolyposis colorectal cancer">Hereditary nonpolyposis colorectal cancer</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_cancer" title="Anal cancer">Anus</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Squamous_cell_carcinoma" class="mw-redirect" title="Squamous cell carcinoma">Squamous cell carcinoma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Upper and/or lower</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastrointestinal_stromal_tumor" title="Gastrointestinal stromal tumor">Gastrointestinal stromal tumor</a></li> <li><a href="/wiki/Krukenberg_tumor" title="Krukenberg tumor">Krukenberg tumor (metastatic)</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver_tumor" title="Liver tumor">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Malignant" class="mw-redirect" title="Malignant">malignant</a>:</i> <a href="/wiki/Hepatocellular_carcinoma" title="Hepatocellular carcinoma">Hepatocellular carcinoma</a> <ul><li><a href="/wiki/Fibrolamellar_hepatocellular_carcinoma" title="Fibrolamellar hepatocellular carcinoma">Fibrolamellar</a></li></ul></li> <li><a href="/wiki/Hepatoblastoma" title="Hepatoblastoma">Hepatoblastoma</a></li> <li><a href="/wiki/Liver_angiosarcoma" title="Liver angiosarcoma">Liver angiosarcoma</a></li></ul> <ul><li><i><a href="/wiki/Benign_tumor" title="Benign tumor">benign</a>:</i> <a href="/wiki/Hepatocellular_adenoma" title="Hepatocellular adenoma">Hepatocellular adenoma</a></li> <li><a href="/wiki/Cavernous_hemangioma" title="Cavernous hemangioma">Cavernous hemangioma</a></li></ul> <ul><li><i><a href="/wiki/Hyperplasia" title="Hyperplasia">hyperplasia</a>:</i> <a href="/wiki/Focal_nodular_hyperplasia" title="Focal nodular hyperplasia">Focal nodular hyperplasia</a></li> <li><a href="/wiki/Nodular_regenerative_hyperplasia" title="Nodular regenerative hyperplasia">Nodular regenerative hyperplasia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Biliary_tract" title="Biliary tract">Biliary tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Bile_duct" title="Bile duct">bile duct</a>:</i> <a href="/wiki/Cholangiocarcinoma" title="Cholangiocarcinoma">Cholangiocarcinoma</a></li> <li><a href="/wiki/Klatskin_tumor" title="Klatskin tumor">Klatskin tumor</a></li></ul> <ul><li><i><a href="/wiki/Gallbladder" title="Gallbladder">gallbladder</a>:</i> <a href="/wiki/Gallbladder_cancer" title="Gallbladder cancer">Gallbladder cancer</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pancreatic_cancer" title="Pancreatic cancer">Pancreas</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Exocrine_pancreas" class="mw-redirect" title="Exocrine pancreas">exocrine pancreas</a>:</i> <a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">Adenocarcinoma</a></li> <li><a href="/wiki/Pancreatic_ductal_carcinoma" class="mw-redirect" title="Pancreatic ductal carcinoma">Pancreatic ductal carcinoma</a></li></ul> <ul><li><i><a href="/wiki/Cyst" title="Cyst">cystic</a> <a href="/wiki/Neoplasm" title="Neoplasm">neoplasms</a></i>: <a href="/wiki/Serous_microcystic_adenoma" class="mw-redirect" title="Serous microcystic adenoma">Serous microcystic adenoma</a></li> <li><a href="/wiki/Intraductal_papillary_mucinous_neoplasm" title="Intraductal papillary mucinous neoplasm">Intraductal papillary mucinous neoplasm</a></li> <li><a href="/wiki/Pancreatic_mucinous_cystic_neoplasm" title="Pancreatic mucinous cystic neoplasm">Mucinous cystic neoplasm</a></li> <li><a href="/wiki/Solid_pseudopapillary_neoplasm" class="mw-redirect" title="Solid pseudopapillary neoplasm">Solid pseudopapillary neoplasm</a></li></ul> <ul><li><a href="/wiki/Pancreatoblastoma" title="Pancreatoblastoma">Pancreatoblastoma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Peritoneum" title="Peritoneum">Peritoneum</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Primary_peritoneal_carcinoma" title="Primary peritoneal carcinoma">Primary peritoneal carcinoma</a></li> <li><a href="/wiki/Peritoneal_mesothelioma" title="Peritoneal mesothelioma">Peritoneal mesothelioma</a></li> <li><a href="/wiki/Desmoplastic_small_round_cell_tumor" class="mw-redirect" title="Desmoplastic small round cell tumor">Desmoplastic small round cell tumor</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style></div><div role="navigation" class="navbox authority-control" aria-label="Navbox" style="padding:3px"><table class="nowraplinks hlist navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Help:Authority_control" title="Help:Authority 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