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The diagnosis and management of gastric cancer

#### Summary points

Age standardised mortality rates for gastric cancer are 14.3 per 100 000 in men and 6.9 per 100 000 in women worldwide.1 Incidence shows clear regional and sex variations—rates are highest in eastern Asia, eastern Europe, and South America and lowest in northern and southern Africa.1 Early diagnosis is crucial because of the possibility of early metastasis to the liver, pancreas, omentum, oesophagus, bile ducts, and regional and distant lymph nodes.2 Using evidence from large randomised controlled trials, meta-analyses, cohort studies, and case-control studies this review aims to outline preventive strategies, highlight the presenting features of gastric cancer, and guide generalists in early diagnosis, referral, and treatment.

#### Sources and selection criteria

We searched PubMed to identify peer reviewed original articles, meta-analyses, and reviews. Search terms were gastric cancer, cancer of the stomach, gastric adenocarcinoma, gastro-oesophageal cancer, gastric neoplasm, and neoplasm of the stomach. We considered only those papers that were written in English, published within the past 10 years, and which described studies that had adequate scientific validity.

Gastric …