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Gastric cancer • Is the third most common cause of cancerrelated death in the world Causes • • • • • • • Diet Helicobacter pylori infection Previous gastric surgery Pernicious anemia Adenomatous polyps Chronic atrophic gastritis Radiation exposure Diet • pickled vegetables, salted fish, salt, and smoked meats correlates with an increased incidence of gastric cancer Smoking • Both for number of cigarettes and for duration of smoking. • Smoking increases the risk of cardiac and noncardiac forms of stomach cancer Helicobacter pylori infection • H pylori may infect 50% of the world's population, but many fewer than 5% of infected individuals develop cancer. • It may be that only a particular strain of H pylori is strongly associated with malignancy Genetic factors • Some 10% of stomach cancer cases are familial in origin Obesity • Obesity increases the risk of gastric cardia cancer. Bisphosphonates • No significant difference was observed for increased risk of esophageal or gastric cancers between the bisphosphonate cohort and the control group Lab Studies • Carcinoembryonic antigen (CEA) is increased in 45-50% of cases • Cancer antigen (CA) 19-9 is elevated in about 20% of cases