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Risk Factors for Stomach Cancer

By Christopher Cutler, M.D.

November is Stomach Cancer Awareness Month. Approximately 22,000 people are diagnosed with stomach cancer every year in the United States, and 11,000 die from it. The physicians at Granite Peaks Gastroenterology would like to make you aware of the risk factors for stomach cancer:

Age, gender, race – Stomach cancer most commonly affects people in their 60s and 70s. Men are two times more likely to develop stomach cancer than women. Stomach cancer is more common in African Americans, Hispanics, and Asians than in Caucasians.

Salt – The risk of stomach cancer increases with a high intake of salt and salt-preserved foods (salted fish).

Nitrates – Nitrates are a natural component of some foods and are also used as a food additive. Diets that are high in processed meats have been associated with a higher rate of stomach cancer. In fact, processed meats (ham, bacon, sausage, jerky) are classified as a group 1 carcinogen.

Diets low in fruits and vegetables – Eating fruits (especially citrus) and vegetables is protective against stomach cancer, possible decreasing the risk by 30-40%. The protection against stomach cancer provided by fruits and vegetables is probably related to their Vitamin C content, which is thought to decrease the formation of carcinogens in the stomach. Cooked vegetables do not offer as much protection as raw vegetables.

Obesity – Excess body weight (BMI greater than 25) is associated with an increased risk of stomach cancer. This risk increases with increasing BMI.

Smoking – The risk of stomach cancer is increased 1.53 fold in smokers, and this risk is even higher in men. The risk decreases after 10 years of smoking cessation.

Alcohol – Heavy alcohol consumption may be a risk for stomach cancer.

Helicobacter pylori – This bacteria, which is present in the stomach of half the world’s population, is a common cause of ulcers and stomach cancer. H pylori is a group 1 carcinogen and may increase the risk of stomach cancer six fold. There is a reduced incidence of stomach cancer after successfully treating H pylori with antibiotics.

Epstein Barr Virus – It is estimated that 5-10% of stomach cancers in the world are associated with this virus.

Occupational exposure – Occupations such as mining, metal processing and rubber manufacturing may increase the risk of stomach cancer.

Gastric surgery – The increased risk of stomach cancer after stomach surgery may be due to the regurgitation of bile and pancreas juice into the remaining stomach.

Blood group – Individuals with blood group A have a 20% increased risk of stomach cancer compared to those with blood groups O, B, and AB.

Family history – This accounts for up to 10% of cases of stomach cancer. There are also many inherited cancer syndromes (Lynch Syndrome) which increase the risk of stomach cancer.

Pernicious anemia – Also known as Vitamin B12 anemia, this may increase the risk of stomach cancer 2-6 fold. Some societies recommend a one-time screening endoscopy in these people to identify pre-cancerous lesions.

Screening everyone for gastric cancer in this country is not recommended. Screening with an endoscopy should be considered for high-risk groups, such as those with a history of: pernicious anemia, adenomas in the stomach, intestinal metaplasia of the stomach, familial adenomatous polyposis, or Lynch Syndrome.

If you have any questions about stomach cancer or its risks, please be sure to contact your medical provider at Granite Peaks Gastroenterology.