Gastric Cancer

Question 1

What is the most common histological subtype of gastric cancer?

Answer 1

Adenocarcinoma

Question 2

What is the 1ary risk factor for gastric cancer?

Answer 2

H. pylori infection

Question 3

How can H. pylori infection lead to gastric cancer?

Answer 3

Persistent infection can induce chronic inflammation, leading to atrophic gastritis, intestinal metaplasia, dysplasia, and eventually, gastric adenocarcinoma.

Question 4

What are some additional risk factors implicated in the development of gastric cancer?

Answer 4

• dietary: smoked foods, high salt, low fruit & veg
• smoking
• alcohol
• pernicious anaemia & atrophic gastritis
• FH
• genetic e.g. Lynch syndrome

Question 5

Clinical features of gastric cancer?

Answer 5

• Dyspepsia or indigestion
• Epigastric pain
• Early satiety or postprandial fullness
• Weight loss
• Anaemia
• N&V
• GI bleeding (e.g., melena, haematemesis)

Question 6

Where can lymphadenopathy be found in gastric cancer?

Answer 6

Supraclavicular lymphadenopathy (Virchow’s node)

Question 7

Referral criteria for gastric cancer?

Answer 7

Upper abdo mass consistent with stomach cancer –> 2ww referral

Dysphagia OR ≥55 y/o with weight loss and any of the following: upper abdo pain, reflux, or dyspepsia –> urgent direct access upper GI endoscopy

Question 8

How is a diagnosis of gastric cancer made?

Answer 8

Endoscopy + biopsy