Stomach Cancer Screening

Stomach cancer is rare today in the United States and routine screening for people at average risk has not proved useful. Screening is only recommended for those at high risk for stomach cancer.

Risk Factors for Stomach Cancer
A risk factor is anything that affects your chance of developing a disease such as cancer. Having one or more risk factors does not mean you will definitely develop stomach cancer, and having no risk factors does not mean you cannot get it. It is advisable to review your family medical history with your doctor and understand your risks for stomach cancer.
 
Although the exact cause of stomach cancer is unknown, researchers have identified many risk factors:

• Helicobacter pylori (bacteria found in the stomach) infection
• Long-term inflammation of the stomach
• Diets high in salted, smoked foods, pickled vegetables or foods containing nitrates and nitrites
• Smoking
• Alcohol use
• Family or personal history of inherited syndromes that increase the risk for stomach cancer
  • Nonpolyposis colon cancer (Lynch syndrome)
  • Familial adenomatous polyposis (which causes cancer of the colon and rectum)
  • Menetrier disease (which causes large gastric folds)
• Previous stomach surgery
• History of stomach polyps
• Age - the average age at diagnosis is 69 years
• Men are more likely to develop stomach cancer than women
• Type A blood
• Pernicious anemia, in which the body’s immune system attacks and destroys the stomach’s mucosal cells
• Exposure to environmental factors, such as radiation or working in the rubber or coal industries

Although no standard screening test for gastric cancer has been developed, several tests can be performed for individuals considered at high risk for developing this type of cancer. These tests include the following:

 

• Upper endoscopy uses a thin, flexible, lighted tube inserted into the mouth and guided down the throat to allow your doctor to view your stomach and remove a tissue sample for biopsy, if needed.
• An upper gastrointestinal (GI) series (also called a barium swallow) consists of X-rays of the upper digestive system (the esophagus, stomach and first section of the small intestine) with use of barium, an imaging agent, to outline any abnormal areas.  
• Blood tests measure levels of pepsinogen in the blood.  Low levels of pepsinogen can suggest chronic gastric issues, which may lead to stomach cancer.