History
Stomach cancer appears in Egyptian papyri from around 1600 BCE. In 1881 Austrian surgeon Theodor Billroth performed the first successful gastrectomy for it, and in the mid-20th century Japan pioneered double-contrast X-ray and endoscopic screening, ushering in early detection. In 1983 Australians Robin Warren and Barry Marshall discovered Helicobacter pylori, and in 1994 the WHO declared it a Group 1 carcinogen. South Korea added endoscopic screening to its national program in 1999; a 2017 study found it cut gastric cancer deaths by about 47%. Rates have fallen in the U.S. for decades, partly thanks to refrigeration reducing salted and smoked foods.
Causes and symptoms
Key risk factors are H. pylori infection, salty, pickled, and smoked foods, smoking, heavy drinking, and family history. The best-known pathway runs from chronic gastritis to atrophic gastritis and intestinal metaplasia, then cancer. Early on there are few symptoms, or ones easily mistaken for indigestion or heartburn. Later signs include unexplained weight loss, loss of appetite, anemia, black stools, and trouble swallowing.
Screening, treatment, and prevention
The U.S. doesn't screen the general population, but people with East Asian ancestry, family history, or long-standing H. pylori may benefit from endoscopy—ask your doctor. Cancer confined to the lining can often be removed endoscopically (ESD) without surgery; more advanced disease needs gastrectomy with lymph node removal plus chemotherapy or immunotherapy. Treating H. pylori lowers risk, especially for close relatives of patients. Cutting salt, not smoking, and eating plenty of produce are the basics. Don't forget colorectal cancer screening too.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Is sedated endoscopy just as accurate?
- Yes, but you'll need someone to drive you home.
- If I treat H. pylori, am I protected?
- It lowers your risk but doesn't eliminate it, so follow your doctor's screening advice.
Sources reviewed: 2026-10-26
References
- Warren, J. R., & Marshall, B. (1983). Unidentified curved bacilli on gastric epithelium in active chronic gastritis. The Lancet, 321(8336), 1273–1275.
- Jun, J. K., et al. (2017). Effectiveness of the Korean National Cancer Screening Program in reducing gastric cancer mortality. Gastroenterology, 152(6), 1319–1328.
- 국립암센터. (2025). 국가암등록통계 2023.