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      Epidemiology of gastric cancer: global trends, risk factors and prevention

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          Abstract

          Gastric cancer remains one of the most common and deadly cancers worldwide, especially among older males. Based on GLOBOCAN 2018 data, stomach cancer is the 5 th most common neoplasm and the 3 rd most deadly cancer, with an estimated 783,000 deaths in 2018. Gastric cancer incidence and mortality are highly variable by region and highly dependent on diet and Helicobacter pylori infection. While strides in preventing and treating H. pylori infection have decreased the overall incidence of gastric cancer, they have also contributed to an increase in the incidence of cardia gastric cancer, a rare subtype of the neoplasm that has grown 7-fold in the past decades. A better understanding of the etiology and risk factors of the disease can help reach a consensus in approaching H. pylori infection. Dietary modification, smoking cessation, and exercise hold promise in preventing gastric cancer, while genetic testing is enabling earlier diagnosis and thus greater survival.

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          Most cited references47

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          Helicobacter pylori update: gastric cancer, reliable therapy, and possible benefits.

          Helicobacter pylori infection contributes to the development of diverse gastric and extragastric diseases. The infection is necessary but not sufficient for the development of gastric adenocarcinoma. Its eradication would eliminate a major worldwide cause of cancer death, therefore there is much interest in identifying how, if, and when this can be accomplished. There are several mechanisms by which H pylori contributes to the development of gastric cancer. Gastric adenocarcinoma is one of many cancers associated with inflammation, which is induced by H pylori infection, yet the bacteria also cause genetic and epigenetic changes that lead to genetic instability in gastric epithelial cells. H pylori eradication reduces both. However, many factors must be considered in determining whether treating this bacterial infection will prevent cancer or only reduce its risk-these must be considered in designing reliable and effective eradication therapies. Furthermore, H pylori infection has been proposed to provide some benefits, such as reducing the risks of obesity or childhood asthma. When tested, these hypotheses have not been confirmed and are therefore most likely false. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
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            Smoking and gastric cancer: systematic review and meta-analysis of cohort studies.

            We conducted a systematic review of studies addressing the relation between cigarette smoking and gastric cancer to estimate the magnitude of the association for different levels of exposure and cancer locations. Published cohort, case-cohort, and nested case-control studies were identified through PubMed, Scopus, and Web of Science searches, from inception to July 2007. Relative risk (RR) estimates referring to the comparison of two categories of exposure (e.g., current smokers vs. never smokers) were combined using a random effects model. Generalized least squares regression was used for trend estimation. Heterogeneity was quantified using the I (2) statistic. Forty-two articles were considered for the systematic review. Comparing current smokers with never smokers: the summary RR estimates were 1.62 in males (95% CI: 1.50-1.75; I (2) = 46.0%; 18 studies) and 1.20 in females (95% CI: 1.01-1.43; I (2) = 49.8%; nine studies); the RR increased from 1.3 for the lowest consumptions to 1.7 for the smoking of approximately 30 cigarettes per day in the trend estimation analysis; smoking was significantly associated with both cardia (RR = 1.87; 95% CI: 1.31-2.67; I (2) = 73.2%; nine studies) and non-cardia (RR = 1.60; 95% CI: 1.41-1.80; I (2) = 18.9%; nine studies) cancers. Our study provides solid evidence to classify smoking as the most important behavioral risk factor for gastric cancer.
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              Changing Trends in Stomach Cancer Throughout the World.

              The paper aims to discuss the global trends in gastric cancer incidence in relation to important factors involved in the pathogenesis of gastric cancer.
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                Author and article information

                Journal
                Prz Gastroenterol
                Prz Gastroenterol
                PG
                Przegla̜d Gastroenterologiczny
                Termedia Publishing House
                1895-5770
                1897-4317
                28 November 2018
                2019
                : 14
                : 1
                : 26-38
                Affiliations
                [1 ]Department of Internal Medicine, SOVAH Health, Hospitalist, Martinsville, USA
                [2 ]Hillman Cancer Center, University of Pittsburgh, PA, USA
                Author notes
                Address for correspondence: Prashanth Rawla, Department of Internal Medicine/Hospitalist, SOVAH Health, Martinsville, VA, 24112 USA. phone: 732-982-7357. e-mail: rawlap@ 123456gmail.com
                Article
                34275
                10.5114/pg.2018.80001
                6444111
                30944675
                ec0f6054-a7df-4b05-b0f1-a8cb2c1bd935
                Copyright: © 2018 Termedia Sp. z o. o.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

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