Chapter

Tumours of the Stomach

The incidence of adenocarcinoma of the stomach is declining worldwide. In some Western countries, rates have been reduced to less than one third within just one generation. In countries with a traditionally high incidence, e.g. Japan and Korea, the reduction is also significant but it will take more time to diminish the still significant disease burden. The main reasons for these good news is a change in nutrition, in particular the avoidance of salt for meat and fish preservation, the lowering of salt intake from other sources, and the availability in many countries of fresh fruits and vegetables throughout the year. Mortality has been further dercreased by significant advances in the early detection of stomach cancer.

Infection with Helicobacter pylori appears to play an important additional aetiological role since it leads to chronic atrophic gastritis with intestinal metaplasia as an important precursor lesion.

The stomach is the main gastrointestinal site for lymphomas and most of these are also pathogenetically linked to H. pylori infection. Regression of such tumours often follows H. pylori eradication.

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