Reducing gastric cancer mortality in the United States: Practical strategies.

Worldwide, gastric cancer is the fifth most diagnosed malignancy, with more than 1 million diagnoses annually, and it also represents the fourth leading cause of cancer death, with approximately 770,000 deaths each year. Relative 5-year survival rates are as high as 95% to 99% when the disease is diagnosed early in its course, but that rate drops to less than 30% when diagnosed in advanced stages. South Korea and Japan, two countries where gastric cancer is endemic, have implemented screening programs that successfully support earlier detection. No routine gastric cancer screening guidelines exist for practice in the United States. This article examines current evidence in support of gastric cancer prevention and screening measures. Two measures are buoyed by the literature: first, prevention of the disease by targeting modifiable risk factors, namely the eradication of Helicobacter pylori , and second, early detection among high-risk groups through endoscopic screening.