Gastric carcinogenesis.

Currently, gastric adenocarcinoma is still a serious healthcare concern, and the second most frequent malignancy worldwide (1). Although overall incidence has seemingly decreased, both its frequency and mortality rate show relevant geographic variability. In Eastern countries, Eastern Europe, and South America the incidence of this disease reaches epidemic proportions, and is the first cause of death from malignant growths (2). In contrast, the incidence of this disease is low in other geographic regions (North America, Western Europe, Australia, New Zealand and Israel). Such differences have been partly attributed to both environmental and nutritional factors in terms of food preservation and preparation, and to infectious factors related to the incidence of H. pylori infection in the population. The potential influence of these factors is such that the increasingly decreased incidence and mortality rate of this disease seen from the 1930’s to the last 10 years has been attributed to dietary and food preservation changes (3-5). However, this change in environmental factors does not fully account for known geographic variations or the various progressions and prognoses this condition may entail. It is nowadays accepted that gastric carcinogenesis is a progressive process in which multiple environmental and epidemiologic, as well as genetic factors play a role, and whose interactions seem to influence not only the development but also the progression of the disease (6).