Gastric Cancer — Prevention and Early Diagnosis —

The morbidity rate of gastric cancer in Japan has gradually decreased and with the increase in number of early gastric cancer, post-therapeutic results have greatly improved. The factors responsible for these phenomena include the decreased incidence of gastric cancer as a result of primary prevention and early detection by secondary prevention. In terms of dietary factors, salt promotes carcinogenesis, whereas green and yellow vegetables, fruit, and green tea suppress it. It is important for the prophylaxis of carcinogenesis to consume abundant fresh vegetables and fruits and to avoid hyperchloric diet. Helicobacter pylori has been implicated in cancer cell proliferation after cancerization. The significance of mass examination for early detection is attracting much attention, but it is not economically feasible in many countries. Occult blood reaction, tumor markers, and a forward endoscope with a small diameter are superior to mass examination in making the diagnosis in terms of specificity, and they are more economical. The kind and characteristics of typical early gastric cancer cases and important points in diagnosis are outlined for the protruding type (0-I, 0-IIa), depressed type (0-IIc, 0-III), and flat type (0-IIb). In the treatment of early gastric cancer, surgical procedures for reduction, such as endoscopic mucosal resection (EMR) and partial resection of the stomach under laparoscopic observation, may be used, contributing to an improved quality of life for the patient.