Gastric Cancer: What Family Physicians Need to Know
DOI:
https://doi.org/10.32782/2415-8127.2026.74.16Keywords:
Helicobacter pylori, risk factors, early diagnosis, family physician, eradicationAbstract
Introduction. Currently, malignant neoplasms are the leading cause of death in 48 countries. In Ukraine, approximately one in five people is diagnosed with cancer during their lifetime, while gastrointestinal malignancies rank first among all cancers in terms of incidence. Objective. To analyze current scientific literature and electronic sources on the epidemiology, risk factors, early detection of gastric cancer, and the role of family physicians in its prevention. Materials and methods. A literature review was conducted using the Scopus, Web of Science, MEDLINE, PubMed, Google Scholar and Global Health databases, as well as publications from the World Health Organization, the Ministry of Health of Ukraine, and other electronic resources. Results. Gastric cancer is one of the most aggressive malignancies with high mortality rates. H. pylori infection is the leading modifiable risk factor. Screening for H. pylori is recommended for individuals at increased risk of gastric cancer, and eradication therapy is indicated for all infected individuals regardless of age. Infection status is determined using invasive and non-invasive diagnostic methods. Primary care physicians play a crucial role in prevention by assessing individual risk factors, identifying high-risk patients, providing preventive counseling, and ensuring continuity of medical care. Conclusions. A comprehensive approach to gastric cancer prevention, including risk assessment, timely detection and eradication of H. pylori, lifestyle modification, early diagnosis of precancerous conditions, and the active involvement of family physicians, is essential for reducing the incidence and mortality of gastric cancer.
References
Chornenka ZhA. Socio-economic determinants of gastric cancer morbidity and mortality. Bukovynskyi Medychnyi Visnyk. 2025;29(4):65-72. [in Ukrainian] doi:10.24061/2413-0737.29.4.116.2025.11.
Sung H, Filho AM, Laversanne M, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2024: GLOBOCAN estimates of incidence and mortality worldwide for 34 cancers in 186 countries. CA Cancer J Clin. 2026 Jul-Aug;76(4):e70090 doi:10.3322/caac.70090.
Khmilievskyi OV. Ministry of Health of Ukraine published detailed cancer incidence statistics in Ukraine [Internet]. Clinical Oncology. 2025. Available from: https://www.clinicaloncology.com.ua/article/35126/moz-oprilyudnilo-rozgornutu-statistiku-onkozahvorjuvanosti-v-ukrayini.
Machlowska J, Baj J, Sitarz M, Maciejewski R, Sitarz R. Gastric cancer: epidemiology, risk factors, classification, genomic characteristics and treatment strategies. Int J Mol Sci. 2020 Jun 4;21(11):4012 doi:10.3390/ijms21114012.
Pardo C, Luzko I, Castillo-Iturra J, Cantú-Germano E, Moreira L. Familial non-hereditary gastric cancer: diagnosis, management, molecular characteristics and future perspective. Cancers (Basel). 2025 Oct 1;17(19):3209 doi:10.3390/cancers17193209.
Morgan E, Arnold M, Camargo MC, Gini A, Kunzmann AT, Matsuda T, et al. The current and future incidence and mortality of gastric cancer in 185 countries, 2020-40: a population-based modelling study. EClinicalMedicine. 2022 Apr 21;47:101404 doi:10.1016/j.eclinm.2022.101404.
Eom SS, Ryu KW, Han HS, Kong SH. A comprehensive and comparative review of global gastric cancer treatment guidelines: 2024 update. J Gastric Cancer. 2025;25(1):153-176 doi:10.5230/jgc.2025.25.e10.
Park JY, Georges D, Alberts CJ, Bray F, Clifford G, Baussano I, et al. Global lifetime estimates of expected and preventable gastric cancers across 185 countries. Nat Med. 2025;31:3020-3027 doi:10.1038/s41591-025-03793-6.
Fedorenko ZP, Sumkina OV, Horokh YL, Ryzhov AYu. Cancer in Ukraine, 2023-2024: incidence, mortality, activities of the oncological service. Bulletin of National Cancer Registry of Ukraine. No. 26. Kyiv: National Cancer Registry of Ukraine; 2025. [in Ukrainian].
Hordiichuk PI, Morskyi DO, Kirkilevskyi SI, Hordiichuk MP, Korol PO, Melnyk DV. The influence of tumor microenvironment on the choice of drug treatment regimen in patients with stage IVa,b gastric cancer considering molecular genetic characteristics. Ukrainian Radiological and Oncological Journal. 2025;33(4):484-497. [in Ukrainian] doi:10.46879/ukroj.4.2025.484-497.
Pepenin MO, Kondratskyi YuM, Dobrzhanskyi OYu, Kolesnyk AV, Horodetskyi AV, Kopchak KV, et al. Perspectives of treatment of peritoneal carcinomatosis of gastric cancer. Narrative review of scientific literature. Klin Onkol. 2025;15(2):87-96. [in Ukrainian] doi:10.32471/clinicaloncology.2663-466X.34391.
Burz C, Pop V, Silaghi C, Lupan I, Samasca G. Prognosis and Treatment of Gastric Cancer: A 2024 Update. Cancers (Basel). 2024 Apr 27;16(9):1708 doi: 10.3390/cancers16091708.
World Cancer Research Fund International. Diet, nutrition, physical activity and stomach cancer. Continuous Update Project Expert Report 2024 [Internet]. London: World Cancer Research Fund International; 2024. Available from: https://www.wcrf.org/wp-content/uploads/2024/10/stomach-cancer-report.pdf.
Wang XQ, Yan H, Terry PD, Wang JS, Cheng L, Wu WA, et al. Interaction between dietary factors and Helicobacter pylori infection in noncardia gastric cancer: a population-based case-control study in China. J Am Coll Nutr. 2012 Oct;31(5):375-84 doi: 10.1080/07315724.2012.10720447.
Rota M, Possenti I, Valsassina V, Santucci C, Bagnardi V, Corrao G., et al. Dose-response association between cigarette smoking and gastric cancer risk: a systematic review and meta-analysis. Gastric Cancer. 2024 Mar;27(2):197-209 doi: 10.1007/s10120-023-01459-1.
Han X, Xiao L, Yu Y, Chen Y, Shu HH. Alcohol consumption and gastric cancer risk: a meta-analysis of prospective cohort studies. Oncotarget. 2017 Jul 12;8(47):83237-83245 doi: 10.18632/oncotarget.19177.
Gapstur SM, Bouvard V, Nethan ST, Freudenheim JL, Abnet CC, English DR, et al. The IARC Perspective on Alcohol Reduction or Cessation and Cancer Risk. N Engl J Med. 2023 Dec 28;389(26):2486-2494. doi: 10.1056/NEJMsr2306723.
Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, et al. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol. 2016 Dec;45:181-188 doi: 10.1016/j.canep.2016.09.011.
Nikulina LM, Solovyova GA. The role of highly toxigenic CagA and VacA strains of Helicobacter pylori in gastric carcinogenesis. Review. Suchasna hastroenterolohiia. 2022;(3-4):42-49. [in Ukrainian] doi:10.30978/MG-2022-3-42.
Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S, et al. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2024 Sep 1;119(9):1730-1753 doi: 10.14309/ajg.0000000000002968.
Yan L, Chen Y, Chen F, Tao T, Hu Z, Wang J, et al. Effect of Helicobacter pylori Eradication on Gastric Cancer Prevention: Updated Report From a Randomized Controlled Trial With 26.5 Years of Follow-up. Gastroenterology. 2022 Jul;163(1):154-162. e3 doi: 10.1053/j.gastro.2022.03.039.
Tkach SM, Kharchenko NV, Dorofieiev AE, Ryzhyi LM. Classification of chronic gastritis and gastropathies and management strategy according to the RE.GA.IN. consensus. Review. Suchasna hastroenterolohiia. 2025;(2):75-84. [in Ukrainian] doi:10.30978/MG-2025-2-75.
Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, Franceschi S. Global burden of gastric cancer attributable to Helicobacter pylori. Int J Cancer. 2015;136(2):487-490 doi:10.1002/ijc.28999.
Moss SF, Shah SC, Tan MC, El-Serag HB. Evolving Concepts in Helicobacter pylori Management. Gastroenterology. 2024;166(2):267-283 doi: 10.1053/j.gastro.2023.09.047.
Collatuzzo G, Santucci C, Malvezzi M, La Vecchia C, Boffetta P, Negri E. Trends in gastric cancer mortality 1990-2019 in 36 countries worldwide, with predictions to 2025, and incidence, overall and by subtype. Cancer Med. 2023 Apr;12(8):9912-9925 doi:10.1002/cam4.5685.
Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017 Aug;153(2):420-429 doi: 10.1053/j.gastro.2017.04.022.
Fadieienko GD, Nikiforova YaV. Possibilities of Helicobacter pylori eradication based on the current Maastricht VI/Florence Consensus recommendations in the world and Ukraine. Suchasna hastroenterolohiia. 2024;(2):90-96. [in Ukrainian] doi:10.30978/MG-2024-2-90.
Kondratiuk N, Paliy I, Zaika S. Analysis of the prevalence of Helicobacter pylori infection and the effectiveness of eradication schemes in patients with upper gastrointestinal tract disorders (according to the results of 13C-urea breath tests for 2006-2019). Prz Gastroenterol. 2021;16(3):229-234 doi:10.5114/pg.2021.108976.
Li D, Jiang SF, Lei NY, Shah SC, Corley DA. Effect of Helicobacter pylori Eradication Therapy on the Incidence of Noncardia Gastric Adenocarcinoma in a Large Diverse Population in the United States. Gastroenterology. 2023 Aug;165(2):391-401. e2 doi: 10.1053/j.gastro.2023.04.026.
Stepanov YuM, Haidar YuA, Maltseva OA. Chronic atrophic gastritis as a precancer: the evolution of ideas from the Sydney Consensus to Maastricht VI. Pathologia. 2022;19(3):227-235. [in Ukrainian] doi:10.14739/2310-1237.2022.3.269011.
Liou JM, Malfertheiner P, Hong TC, Cheng HC, Sugano K, Shah S, et al. Asian Pacific Alliance on Helicobacter and Microbiota (APAHAM). Screening and eradication of Helicobacter pylori for gastric cancer prevention: Taipei Global Consensus II. Gut. 2025 Oct 8;74(11):1767-1791 doi: 10.1136/gutjnl-2025-336027.
Shah SC, Wang AY, Wallace MB, Hwang JH. AGA Clinical Practice Update on Screening and Surveillance in Individuals at Increased Risk for Gastric Cancer in the United States: Expert Review. Gastroenterology. 2025 Feb;168(2):405-416.e1 doi: 10.1053/j.gastro.2024.11.001.
Ministry of Health of Ukraine. Standard of medical care "Gastric cancer": approved by the Order of the Ministry of Health of Ukraine No. 1926 dated November 10, 2023 [Internet]. Kyiv: Ministry of Health of Ukraine.
Malfertheiner P, Megraud F, Rokkas T, Gisbert JP , Liou J-M ,Schulz C, et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence Consensus Report.Gut. 2022;71(9):1724–1762 doi: 10.1136/gutjnl-2022-327745.
Krasnoselskyi MV, Sukhin VS, Hertman VZ, Simonova-Pushkar LI. Possibilities of diagnostic and prognostic use of matrix metalloproteinases in oncogynecology. Visnyk VDNZU "Ukrainska medychna stomatolohichna akademiia". 2018;18(1):313-317. [in Ukrainian] Available from: https://repository.pdmu.edu.ua/handle/123456789/11523.
Ajani JA, D'Amico TA, Bentrem DJ, Corvera CU, Das P, Enzinger PC, et al. Gastric Cancer, Version 2. 2025, NCCN Clinical Practice Guidelines In Oncology. J Natl Compr Canc Netw. 2025 May;23(5):169-191 doi:10.60044/jnccn.2025.0022.
