Gastric Cancer: Emerging Trends in Prevention, Diagnosis, and Treatment

Gastroenterol Clin North Am. 2022 Sep;51(3):501-518. doi: 10.1016/j.gtc.2022.05.001.

Abstract

Gastric adenocarcinoma (GC) is the fourth leading cause of global cancer mortality, and the leading infection-associated cancer. Helicobacter pylori is the dominant risk factor for GC and classified as an IARC class I carcinogen. Surveillance of gastric premalignant conditions is now indicated in high-risk patients. Upper endoscopy is the gold standard for GC diagnosis, and image-enhanced endoscopy increases the detection of gastric premalignant conditions and early gastric cancer (EGC). Clinical staging is crucial for treatment approach, defining early gastric cancer, operable locoregional disease, and advanced GC. Endoscopic submucosal dissection is the treatment of choice for most EGC. Targeted therapies are rapidly evolving, based on biomarkers including MSI/dMMR, HER2, and PD-L1. These advancements in surveillance, diagnostic and therapeutic strategies are expected to improve GC survival rates in the near term.

Keywords: Diagnosis; Gastric cancer; Prevention; Treatment.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • B7-H1 Antigen / therapeutic use
  • Carcinogens
  • Gastric Mucosa / pathology
  • Gastroscopy
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / diagnosis
  • Helicobacter Infections* / drug therapy
  • Helicobacter pylori*
  • Humans
  • Precancerous Conditions* / diagnosis
  • Precancerous Conditions* / pathology
  • Precancerous Conditions* / therapy
  • Stomach Neoplasms* / diagnosis
  • Stomach Neoplasms* / etiology
  • Stomach Neoplasms* / prevention & control

Substances

  • B7-H1 Antigen
  • Carcinogens