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. 2018 Oct;155(4):939-944.
doi: 10.1053/j.gastro.2018.06.044. Epub 2018 Jun 30.

Past Questions and Current Understanding About Gastric Cancer

Jason C Mills  1 , Linda C Samuelson  2
Affiliations

Past Questions and Current Understanding About Gastric Cancer

Jason C Mills et al. Gastroenterology. 2018 Oct.
No abstract available

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Figures

Figure
Figure. Gastric Cancer Then and Now
In some cases, we have learned a lot since 1958 when Boles wrote a review in Gastroenterology on gastric cancers. Top-Boles had identified a surprising decline in deaths due to gastric cancer in his 1955 article on the subject in Gastroenterology (graphed are white male deaths). That trend continued through the end of the 20th Century and then has since leveled off (note log axis). Data in graph on right estimated from multiple sources but primarily based on the American Cancer Society online tool (https://cancerstatisticscenter.cancer.org). The reasons for the decline are not entirely clear but are discussed in the text. Bottom- Gastroenterologists have struggled with distinguishing benign gastric ulcers from cancer since the 18th Century and the relationship between the two had been unclear until the role of H pylori in ulcers and cancer was discovered. Depicted is a roentgenogram with contrast (Fig. 3 from the first article in the first issue of Gastroenterology) from a 58 year-old male who had black stools and 6 weeks of epigastric distress relieved somewhat by food; there was no weight loss. Achlorhydria and slight anemia with constricted antrum led to concern about gastric cancer and exploratory laparotomy with pathology showing a punched-out 1 cm ulcer and ultimate diagnosis of chronic peptic ulcer. At right, a portion of a photomicrograph from one of the early Gastroenterology papers discussing pathology caused by H pylori, the bacteria that were, at the time, being revealed to be the primary cause of both peptic ulcers and gastric cancer.
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