Recently, gastroscopy revealed a case of a 28-year-old patient who had been suffering from gastric disease for many years and took gastric medicine every time he had an attack. Gastric cancer is generally considered to be related to Helicobacter pylori infection, environmental factors, genetic factors, etc. It occurs mostly in middle-aged and old people, accounting for 2/3 of those aged 40-60 years, but in recent years, there is a trend of increasing gastric cancer in young people, and the higher incidence of gastric cancer in women may be related to female estrogen receptors and cytoplasmic estradiol, which may affect gastric mucosal barrier function through the neuroendocrine system. Gastric cancer in young people is characterized by many advanced cases, short course and high malignancy. Due to the lack of specificity of early stage of cancer, it is easy to be misdiagnosed and missed clinically, and the misdiagnosis rate is reported to be as high as 80%, and the main symptoms are upper abdominal pain and abdominal discomfort, other symptoms include gastrointestinal bleeding, fullness and vomiting after eating, and emaciation, etc. Because the early manifestations are similar to gastritis and ulcer disease, and the symptoms can be reduced by therapeutic drugs, coupled with the fact that it is not easy for young people to pay attention to it. The diagnosis and treatment are delayed because the early manifestations are similar to those of gastritis and ulcer disease, and the symptoms can be alleviated by therapeutic drugs, and because it is not easy to attract attention at a young age, and some people are afraid of gastroscopy, thus delaying the diagnosis and treatment. We suggest that young people who have one of the following clinical manifestations should be highly alert to gastric cancer: 1. 3. Patients with unexplained gastrointestinal bleeding and anemia, excluding liver, biliary and pancreatic diseases and long-term use of drugs damaging the gastric mucosa, who have been ineffective in general hemostasis and anti-anemia treatment, especially those with positive family history; 4. Patients with upper gastrointestinal symptoms accompanied by abdominal masses and even obstructive symptoms should undergo upper gastrointestinal imaging and endoscopy for clear diagnosis. Gastroscopy and pathological examination are the gold standard for the diagnosis of this disease. Due to the improvement of the doctor’s operation level and the softness of the endoscope, the uncomfortable degree of gastroscopy is significantly reduced, and patients can perform painless gastroscopy when needed, which is basically painless.