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World J Clin Oncol. Sep 10, 2012; 3(9): 128-136
Published online Sep 10, 2012. doi: 10.5306/wjco.v3.i9.128
Advances in gastric cancer prevention
Antonio Giordano, Letizia Cito
Antonio Giordano, Letizia Cito, INT-CROM, “Pascale Foundation” National Cancer Institute-Cancer Research Center, 83013 Mercogliano, Italy
Antonio Giordano, Human Pathology and Oncology Department, University of Siena, 53100 Siena, Italy
Author contributions: Cito L wrote this manuscript; and Giordano A supervised and edited the final version.
Correspondence to: Letizia Cito, PhD, INT-CROM, “Pascale Foundation” National Cancer Institute-Cancer Research Center, 83013 Mercogliano, Italy. letizia.cito@cro-m.eu
Telephone: +39-825-1911736 Fax: +39-825-1911705
Received: April 20, 2012
Revised: August 19, 2012
Accepted: September 6, 2012
Published online: September 10, 2012

Gastric cancer is a multifactorial neoplastic pathology numbering among its causes both environmental and genetic predisposing factors. It is mainly diffused in South America and South-East Asia, where it shows the highest morbility percentages and it is relatively scarcely diffused in Western countries and North America. Although molecular mechanisms leading to gastric cancer development are only partially known, three main causes are well characterized: Helicobacter pylori (H. pylori) infection, diet rich in salted and/or smoked food and red meat, and epithelial cadherin (E-cadherin) mutations. Unhealthy diet and H. pylori infection are able to induce in stomach cancer cells genotypic and phenotypic transformation, but their effects may be crossed by a diet rich in vegetables and fresh fruits. Various authors have recently focused their attention on the importance of a well balanced diet, suggesting a necessary dietary education starting from childhood. A constant surveillance will be necessary in people carrying E-cadherin mutations, since they are highly prone in developing gastric cancer, also within the inner stomach layers. Above all in the United States, several carriers decided to undergo a gastrectomy, preferring changing their lifestyle than living with the awareness of the development of a possible gastric cancer. This kind of choice is strictly personal, hence a decision cannot be suggested within the clinical management. Here we summarize the key points of gastric cancer prevention analyzing possible strategies referred to the different predisposing factors. We will discuss about the effects of diet, H. pylori infection and E-cadherin mutations and how each of them can be handled.

Keywords: Cancer, Prevention, Diet, Vegetables, Cell cycle, Lifestyle, Helicobacter pylori