Prevention and early diagnosis of gastric cancer

       The death of famous host Fang Jing due to gastric cancer brought us a huge shock.  In fact, gastric cancer has always been highly prevalent in China, and the number of gastric cancer in China accounts for about 50% of the number of gastric cancer in the world. In general, the incidence of gastric cancer shows an increasing trend with age, and it is common in the age group of 40-60 years old, while male patients are about twice as many as female. Nowadays, the incidence of stomach cancer is increasing nationwide and is trending younger, and young and middle-aged people also need to pay attention to cancer prevention knowledge.  The reality of gastric cancer diagnosis and treatment is still grim: high incidence rate, high recurrence and metastasis rate, high mortality rate and low early diagnosis rate, low radical resection rate and low 5-year survival rate. Therefore, it is necessary to do a good job in popularizing science and spreading basic knowledge of gastric cancer prevention.  High-risk groups: H. pylori infection, atrophic gastritis, family history of tumor, certain geographical areas, poor dietary habits, etc. It is well established that H. pylori is the primary causative factor for gastric cancer, but H. pylori and gastric cancer are not equal, but only one of the important factors, individual factors and environmental factors are also crucial.  The existence of areas with high incidence of gastric cancer may be related to dietary habits and geographical environmental factors: the northwest region represented by Qinghai, Gansu and Ningxia, and the southeast coastal regions such as Jiangsu, Shanghai, Zhejiang and Fujian have a high incidence of gastric cancer. Among them, Linqu County of Shandong Province, Zhuanghe County of Liaoning Province and Changle County of Fujian Province are the most representative.  People with long-term smoking, drinking alcohol, often eating pickled or barbecued food, high-salt food and other bad habits. High levels of carcinogens or former carcinogens such as nitrite, fungal toxins, and polycyclic aromatic hydrocarbon compounds in food can increase the risk of cancer.  In two or three generations of relatives who have had digestive tumors or other tumors, their chances of getting stomach cancer will be relatively higher. On the other hand, also due to the family aggregation of H. pylori, usually in large families living and eating together, H. pylori will infect each other leading to a higher risk of stomach cancer.  Health awareness is important China is a country with high incidence of gastric cancer, more than half of the new gastric cancer in the world is in China, compared to Korea and Japan, our rate of early gastric cancer is very low, most patients are already in the middle and late stage when found, the treatment effect is greatly reduced. In contrast, Korea and Japan are also countries with high incidence of stomach cancer, but their early detection rate is very high, which makes the cure rate much higher.  As with all cancers, the earlier gastric cancer is detected, diagnosed and treated, the better the prognosis is. Paying attention to early detection can win valuable time for gastric cancer treatment. The cure rate of early gastric cancer located under the mucosa can be over 90%. Therefore, in fact, we do not need to be afraid of cancer, early detection and early diagnosis can fight for the chance of cure for ourselves, and we can avoid “regretting that we did not pay attention to it or did not know about it” by mastering health knowledge.  In order to achieve early detection and treatment, we should first learn to observe the signs and symptoms of stomach cancer, such as unexplained indigestion and other symptoms, which are relatively stubborn, mainly manifested as decreased appetite, abdominal fullness and discomfort after eating, acid reflux, belching, accompanied by weight loss or anemia.  People who did not have stomach pain in the past have recurrent stomach pain in the recent past; or although they had stomach pain in the past, the intensity, nature and pattern of pain attacks have changed recently, and the drugs that were effective in treatment have become poor or ineffective, etc. Once these conditions occur, it is important to go to a regular hospital for gastroscopy as early as possible.  However, these symptoms are often not specific, and the pathogenesis of gastric cancer is still unclear, so we should also have regular medical checkups, starting from the age of 50 for people in general, and about 10 years in advance for people with high risk of gastric cancer, to have targeted gastroscopy, which should be done every 3-10 years, according to doctors’ recommendations. The current gastroscopy not only has high clarity, but also can chemically stain the mucosa under gastroscopy, which greatly improves the identification rate of lesions that are not significant under conventional endoscopic examination.  In addition we need to develop good dietary and lifestyle habits, especially the above mentioned people with high risk factors need to pay attention to my awareness of precautions and take the initiative to understand their health status regularly.