Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice | May 2025-16

16_Sun Shah Gastric Cancer Prevention

Pdf Summary

Dr. Shailja C Shah's presentation, "Preventing Gastric Cancer," highlights the crucial role of prevention and early detection in addressing gastric cancer, the 5th most common cancer globally and the 4th leading cause of cancer mortality. Nearly 90% of cases are linked to H. pylori and modifiable factors. The goal is to reduce mortality through primary prevention (e.g., H. pylori eradication) and secondary prevention (e.g., early detection via screening).<br /><br />In the U.S., studies indicate a high prevalence of H. pylori among veterans, particularly in non-White groups. Eradicating H. pylori has been shown to reduce gastric cancer incidence by 36% and mortality by 22%, emphasizing the importance of timely treatment. The 2024 ACG guidelines advocate for testing and confirming eradication in at-risk individuals.<br /><br />Gastric intestinal metaplasia (GIM) and dysplasia require careful monitoring, as the progression risk is linked to various factors such as family history and the severity of atrophic gastritis. Surveillance is recommended for high-risk individuals, which may be cost-effective for high-risk U.S. populations.<br /><br />Effective gastric cancer prevention involves a risk-stratified approach to screening and surveillance endoscopy, focusing on early detection in high-risk populations (e.g., immigrants from high-incidence regions, non-White individuals, and those with persistent H. pylori). Quality endoscopic procedures are crucial, as studies show significant variations in lesion detection.<br /><br />Key takeaways include identifying high-risk populations for targeted prevention efforts, timely H. pylori eradication to prevent progression, and rigorous screening and surveillance practices using high-quality endoscopy to improve early detection rates. Addressing modifiable risk factors, such as diet and smoking, is also essential in reducing gastric cancer incidence.

Keywords

gastric cancer

H. pylori eradication

early detection

cancer prevention

screening

intestinal metaplasia

ACG guidelines

high-risk populations

endoscopy

modifiable risk factors