Why is the second largest cancer in China found when most of the late

  Gastric cancer is one of the most common malignancies. According to the World Health Organization, gastric cancer accounts for the fourth leading cause of cancer deaths worldwide in 2015 . 1 All of East Asia, including our own, belong to the high incidence area of ??gastric cancer. Therefore, the incidence of gastric cancer in our country is also high, especially in the population aged 40-60 years. The male is higher than the female.


According to the latest "Cancer Incidence Rates in Five Continents" published by the World Cancer Institute in 2017, gastric cancer is the second largest cancer in our country. The incidence of gastric cancer in men is 40/10 million and that in women is 20/10.

In addition to the high incidence of gastric cancer is more frightening is often found when many people are already late. So, how to prevent stomach cancer, how to detect gastric cancer in the early stage is very important for each of us.


Five risk factors associated with gastric cancer


In general, when we find out the cause of the disease, it is easy to avoid. Unfortunately, the etiology and pathogenesis of gastric cancer have not yet been completely clear, the current study that the occurrence of gastric cancer is the result of a combination of multiple factors, and generally more relevant to the following factors:


1, genetic


The incidence of gastric cancer family aggregation tendency. The incidence of immediate relatives in patients is 2-4 times higher than that of normal people. Researchers think this is because some genetic factors make susceptible people more susceptible to cancer under the same living environment conditions.


2, the environment


The incidence of different countries and regions have significant differences.


In foreign studies, the incidence of gastric cancer in the first generation from Japan (East Asia, high incidence of gastric cancer) to the United States (North America, low-incidence area of ??gastric cancer) after World War II was similar to that of Japanese residents, and the second generation had obvious Decline, the incidence of third-generation gastric cancer and the United States has similar local residents, suggesting that the incidence of gastric cancer and environmental factors, the most important of which are dietary factors.


Many delicious foods contain carcinogens or pre-cancerous substances: there are a lot of nitrite in the preserved food, while the content of nitrite in human gastric juice is positively correlated with the incidence of gastric cancer. The fried foods produce polycyclic Aromatics; Smoked fish contains more 3,4-benzopyrene; Moldy foods contain more mycotoxins.


These names pronounced mouthful of stuff in the body metabolic transformation, and nitroso compounds can play a synergistic carcinogenic effect.


In addition, high salt, low protein diet, lack of fresh vegetables and fruits may increase the risk of gastric cancer. Smoking may increase the risk of gastric cancer to some extent, but no obvious correlation between drinking and gastric cancer has been found.


3, infection


Helicobacter pylori (Hp) is a type I carcinogen listed by the World Health Organization. The incidence of gastric cancer is positively correlated with Hp infection rate. Hp mainly causes gene damage and mutation, induces apoptosis of gastric mucosal epithelial cells, and at the same time weakens the ability of the stomach to remove nitrite and oxygen free radicals, thereby increasing the risk of gastric cancer.


4, genetic changes


Proliferation and apoptosis of human cells are regulated by many oncogenes and tumor suppressor genes. Gene abnormalities, deletions, dislocation and changes in the level of expression levels will affect the degree of risk of gastric cancer and the occurrence of gastric malignancy after the disease.


5, precancerous changes


Speaking of gastric cancer, we must mention a concept called "premenstrual changes", referring to lesions that have a strong propensity to malignant, including pre-cancerous conditions and precancerous lesions. These concepts can often be seen on gastroscopy reports.


Among them, the precancerous state belongs to the concept of clinical diagnosis, including chronic atrophic gastritis , gastric polyps, gastric ulcer , postoperative stomach; precancerous lesions are pathological diagnosis concepts, including intraepithelial neoplasia, intestinal metaplasia and so on.


Premenstrual changes are not necessarily advanced to cancer, but they are more likely to develop malignancy than normal people without these pathologies. Take a car tire, for example, a scratched tire, the risk of a flat tire is certainly higher than the appearance of a good tire, but not to say that the scratched tire will burst, the tire shape intact will be able to use the end of life , But the probability of accidents is different.


Of course, these precancerous changes still need to be given enough attention. If these words appear in the diagnostic report, then you need to pay more attention to follow the doctor's advice for regular review and treatment to avoid the difficult to clean up the outcome.


Early gastric cancer is not easy to find


Gastric cancer can be divided into early gastric cancer and advanced gastric cancer, the symptoms and disease progression are closely related. Early gastric cancer lesions confined to the mucosa and submucosa, so most of the symptoms, developed to a certain extent, there will be abdominal discomfort, acid reflux, satiety and other non-specific dyspeptic symptoms, and when the hiding, seizures and remissions Alternating, it is difficult to cause enough attention, but also easily confused with other diseases. Therefore, the majority of patients with early gastric cancer are found during routine health examination.


Once the disease progresses to advanced stage, some obvious symptoms will appear. Most patients are also treated because of these symptoms. The most common are upper abdominal pain, accompanied by progressive loss of appetite and weight loss, hematemesis, melena , There are some patients will appear pyloric obstruction , complications such as perforation and tumor-related symptoms of metastasis. (From this point of view, Zhuge Liang did not work as a premature death die much like to die of stomach cancer, eating less, weight loss, easily vomit blood, is not very consistent?)


Endoscopy can screen for early gastric cancer


The most reliable way to diagnose gastric cancer is by endoscopy and biopsy. Most of the early gastric cancers without symptoms are diagnosed almost entirely with endoscopy, and CT and MR can be used to determine the extent of gastric cancer, the depth of invasion, Of the relationship for the development of surgical programs to provide the basis.


Our neighbor, Japan, is also a country with a high incidence of gastric cancer, but Japan is the world leader in the diagnosis and treatment of gastric cancer (even in most hospitals, the gastroscope is also the Japanese brand "Fuji" and "Olympus") - the most crucial Is to grasp the early diagnosis of this ring, which is not unrelated to their promotion of gastroscopy screening.


It is reported that Japan has completed about 15 million gastroscopy annually, with a relative population of 130 million. This proportion has been considerable, so that the diagnosis rate of early gastric cancer can reach an astonishing 50% -70%. In contrast, China's endoscopy, especially in the elderly population screening popularity is not satisfactory, many people do not understand the importance of gastroscopy - because of fear of inspection discomfort and exclusion of endoscopy, often Missed the best time to find the hidden dangers. People do not know terrible gastroscopy, but more terrible gastric cancer.


The staging of gastric cancer diagnosis largely determines the prognosis of the disease, and then smart doctor, then superb surgical skills, but also less than the early detection of the tumor.


Prevention of gastric cancer, to start from these three aspects


Having said that, I am afraid we are most concerned about how to prevent the occurrence of gastric cancer, or can identify possible symptoms as soon as possible in order to early detection, early diagnosis, early treatment.


At the beginning of this article have said that there are several factors related to gastric cancer. Among them, we can do nothing about genetic and genetic changes, but other pathogenic factors are still human intervention.


· From the perspective of lifestyle, pay attention to food hygiene, to avoid fresh and mildewed foods to reduce the possible intake of carcinogenic substances; do not smoke; diet do not eat too salty, try to eat less pickled, smoked and oil Fried foods; eat more fresh vegetables and fruits; antioxidant vitamins such as vitamin A, vitamin C, vitamin E, β-carotene, green tea polyphenols and so have a certain anti-cancer effect, rich in nutrients of these foods Can also be appropriate to increase intake.


· From a disease point of view, clearly atrophic gastritis , gastric mucosal intestinal metaplasia, dysplasia, gastric ulcer, gastric surgery history of the population, if the recent pain intensity, nature, attack time has changed, the original effective drug changes was ineffective in chronic stomach in patients, black stools, weight loss, fatigue, loss of appetite and other symptoms, immediate family members have a history of stomach cancer population, need to improve attention, close follow-up for timely treatment. For patients with gastric-based disease and found to be positive for Helicobacter pylori (Hp), Hp should be considered as appropriate.


· From the perspective of prevention screening of view, people over age 40, every 1--2 years endoscopy should be performed once. In view of the trend of gradual rejuvenation of gastric cancer, even those under 40 years of age, if it involves more of the above risk factors or have repeated stomach discomfort, they should also undergo endoscopy as early as possible, do not hide their dilemma or deceive themselves.





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