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While stomach cancer is typically more common in older populations, genetic mutations and inherited conditions can increase susceptibility in younger people.
Prevention strategies play a crucial role in reducing the incidence of stomach cancer, particularly in high-risk populations
Stomach cancer, traditionally seen in older individuals (70-80 % of gastric cancers are diagnosed in individuals > 60 years), is increasingly affecting younger patients, a troubling trend that has raised concern among medical professionals. Several factors may contribute to this rise, though much remains to be understood. Dr Subhash Agal, Head, Gastroenterology, Kokilaben Dhirubhai Ambani Hospital, Mumbai shares some potential reasons why stomach cancer is becoming more common in younger people are as follows:
Changes in Diet and Lifestyle
Processed Foods and Poor Diets: The consumption of processed foods, high in salt, preservatives, and artificial additives, has increased worldwide. These dietary habits may contribute to the development of stomach cancer, as high salt intake and processed meats are known to irritate the stomach lining, potentially leading to cancer
Tobacco and Alcohol Use: Smoking and excessive alcohol consumption have long been linked to several types of cancer, including stomach cancer. The carcinogens in tobacco smoke and alcohol can damage the stomach lining and increase the risk of cancer development
Obesity: The rising obesity rates globally are another risk factor. Obesity is linked to a variety of cancers, including gastric cancer, as it can lead to chronic inflammation and changes in hormone levels, both of which are thought to play a role in cancer development
Helicobacter pylori Infection
Helicobacter pylori (H. pylori), a bacterium that causes stomach ulcers, is a well-known risk factor for stomach cancer. Chronic infection with H. pylori can lead to inflammation of the stomach lining and increases the risk of developing gastric cancer. Although H. pylori infection rates have declined in some parts of the world, the bacteria remains a significant risk factor, especially in regions where sanitation and hygiene are poor.
Genetic Factors
Hereditary Factors: While stomach cancer is typically more common in older populations, genetic mutations and inherited conditions can increase susceptibility in younger people. Hereditary diffuse gastric cancer (HDGC), which is linked to mutations in the CDH1 gene, is one such example. Individuals with these genetic mutations are at higher risk for developing stomach cancer at a younger age
Family History: A family history of stomach cancer may increase the risk for younger individuals, even in the absence of known genetic syndromes
Environmental Exposure
Pollution and Chemicals: Environmental factors such as air pollution and exposure to carcinogenic chemicals may also play a role in the rising rates of stomach cancer in younger populations
Impact of Screening and Early Detection
The Role of Screening
While there is no routine screening for stomach cancer in most countries, increased awareness and early diagnostic testing (especially for individuals with family histories or known risk factors) could lead to early detection. The rise in younger cases may be partially attributed to better detection techniques.
Challenges in Screening
On the other hand, screening for stomach cancer remains underdeveloped in many parts of the world, especially in regions where the disease is less common. This lack of routine screening makes early diagnosis difficult, contributing to late-stage diagnosis when the prognosis is poorer
Dr Agal shares Treatment Challenges for Younger Patients
- Tailored Treatment ApproachesTreating stomach cancer in younger patients may require different approaches compared to older patients. Younger individuals often have a better overall health status and may be able to tolerate more aggressive treatments, such as chemotherapy or surgery. However, they also face long-term health concerns that must be taken into account, including the potential for infertility, the effects of radiation or chemotherapy on growth and development, and the risk of recurrence
- Personalized MedicineAdvances in personalized or precision medicine are helping to provide younger patients with more targeted treatments based on the genetic make-up of their cancer. Molecular profiling and genetic testing can reveal mutations or specific characteristics of the cancer that can guide therapy, leading to better outcomes
Prevention and Awareness
Early Intervention
Prevention strategies play a crucial role in reducing the incidence of stomach cancer, particularly in high-risk populations. This includes promoting a healthy diet, regular physical activity, and smoking cessation. Screening for individuals with a family history of gastric cancer or genetic predispositions could help identify early-stage disease before it progresses.
Public Health Campaigns
Public awareness campaigns that educate younger people about the risks of stomach cancer—such as the importance of maintaining a healthy diet, avoiding smoking, and seeking medical advice for persistent gastrointestinal symptoms—are vital in curbing the rise in cases. Emphasizing the importance of early detection, especially for individuals with family histories or chronic H. pylori infections, can lead to better outcomes.
