Stomach (gastric) cancer is common worldwide and often diagnosed late. Key preventable risks include Helicobacter pylori infection, high salt intake, smoked/pickled foods, and smoking. Japan and Korea reduced gastric cancer deaths through salt reduction, H. pylori programs, and endoscopic screening. Individuals can lower risk by testing/treating H. pylori when indicated, reducing salt, eating more vegetables, quitting smoking, and following surveillance when precancerous changes exist.

Overview

Stomach (gastric) cancer remains a major global health problem. According to GLOBOCAN 2020 it was the fifth most common cancer and the fourth leading cause of cancer death worldwide. Many cases are still diagnosed at an advanced stage, when treatment is less likely to be curative.

Major risk factors

Helicobacter pylori infection

Helicobacter pylori is a main cause of chronic gastritis and is classified as a Group 1 carcinogen. Long-term infection increases the risk of atrophic gastritis, intestinal metaplasia, and eventually gastric cancer. Eradicating H. pylori reduces cancer risk, especially when done before advanced precancerous changes develop.

Diet and salt

High salt intake and frequent consumption of salted, smoked, or pickled foods increase gastric cancer risk. Salt damages the stomach lining and enhances the harmful effects of H. pylori and dietary nitrosamines.

Smoking and alcohol

Smoking increases the risk of gastric cancer, and alcohol can compound other risks. Quitting tobacco lowers risk over time.

Age, sex, and precancerous conditions

Risk rises with age and is generally higher in males. Precancerous changes - such as atrophic gastritis, intestinal metaplasia, and gastric polyps - substantially increase lifetime risk and often require surveillance.

Prevention and population lessons

Japan and South Korea have seen substantial declines in gastric cancer mortality over recent decades. Several coordinated measures contributed:

  • Reduced average salt intake through public health campaigns and changes in food preparation.
  • Widespread use of endoscopic screening programs in high-risk populations, which detect early cancers amenable to curative treatment.
  • Programs to identify and treat H. pylori infection; many health systems expanded access to eradication therapy in the 2010s.
These approaches - lowering salt, treating H. pylori, screening high-risk groups, and reducing smoking - work together to cut incidence and deaths.

What individuals can do

  • Ask your clinician about H. pylori testing if you have chronic stomach symptoms or a family history of gastric cancer. Treatment reduces future risk, especially before advanced changes occur.
  • Reduce salt and limit smoked, salted, and pickled foods. Increase fresh vegetables and fruits.
  • Stop smoking and limit heavy alcohol use.
  • If you have precancerous changes (atrophic gastritis, intestinal metaplasia) follow recommended surveillance with your doctor.

Bottom line

Many drivers of gastric cancer are modifiable. Public health actions - salt reduction, tobacco control, H. pylori testing and treatment, and targeted screening - have reduced deaths in high-risk countries and offer a practical roadmap for prevention elsewhere.

FAQs about Health Service

Does Helicobacter pylori cause stomach cancer?
Yes. H. pylori causes chronic gastritis and is a Group 1 carcinogen. Eradicating the infection lowers the risk of developing gastric cancer, particularly when done before advanced precancerous changes appear.
How does salt affect stomach cancer risk?
High salt intake damages the stomach lining and increases the harmful effects of H. pylori and dietary nitrosamines. The WHO recommends keeping salt intake under 5 grams per day to reduce several health risks.
Can screening prevent death from gastric cancer?
In high-risk countries, regular endoscopic screening detects early, treatable cancers and has contributed to lower mortality. Routine population screening is most useful where incidence is high.
Which lifestyle changes most reduce risk?
Test and treat H. pylori when appropriate, reduce salt and salted/preserved foods, eat more fresh fruits and vegetables, and stop smoking.