Stomach cancer is increasingly being detected earlier, raising hopes for survival
Stomach cancer, the disease that killed country music star Toby Keith in 2024, is typically difficult to catch early and tends to be discovered at an advanced stage when cancer cells have spread, researchers reported Saturday at Digestive Disease Week, a major international conference for doctors and researchers in gastroenterology, liver diseases and endoscopy.
Advances in the tools used to scrutinize the upper gastrointestinal tract have made it possible to get a clearer view of the stomach, allowing doctors to see small tumors that previously wouldn't have been detected, according to the study's lead author, Dr. Mohamed Tausif Siddiqui, a gastroenterology, hepatology and nutrition fellow at the Cleveland Clinic.
'They used to be detected after they metastasized, which is why there were very poor outcomes,' Siddiqui said in an interview. 'The whole paradigm is changing, with more and more local cancers and fewer metastatic cancers being detected.'
Newer endoscopes, thin tubes used to look inside the body, provide higher-definition views of the upper gastrointestinal tract, Siddiqui said. The cameras that are guided into the patient's stomach have the capacity to zoom in on suspect areas.
Siddiqui and his colleagues analyzed data from the National Cancer Institute's SEER-22 database and found that diagnoses of early-stage stomach cancer rose steadily from 2004 to 2021.
In contrast, more advanced cases — when the cancer had already spread to nearby lymph nodes and/or distant organs — had dropped significantly.
In 2004, early-stage stomach cancer, also called gastric cancer. was detected at a rate of 1.94 per 100,000. By 2021, that number had risen to 2.97 per 100,000. That's compared to 2.55 per 100,000 for late-stage cancers detected in 2004 and 2.35 per 100,000 detected in 2021.
The American Cancer Society predicts that in the U.S. in 2025, there will be around 26,500 new cases of stomach cancer diagnosed and more than 10,800 deaths.
More cases of stomach cancer are being diagnosed in people ages 50 and younger, a separate study being presented at the meeting by Cleveland Clinic researchers found.
What are causes and symptoms of stomach cancer?
There are many factors that can raise a person's risk of developing stomach cancer, including infection with Helicobacter pyloribacteria, genetic predisposition and a history of smoking, Siddiqui said.
H. pylori infections lead to inflammation in the stomach and have been shown to cause ulcers.
Early signs of stomach cancer include:
Acid reflux that can't be controlled with acid suppressing medications.
Abdominal discomfort and excessive burping after eating.
Stomach cramping.
Unexplained abdominal pain.
Anemia.
Weight loss, with no explanation.
The researchers hope that the new findings will lead to guidelines for stomach cancer screening, similar to recommendations for colon cancer.
Currently in the U.S. people get checked for the di s ease only if they have symptoms or a family history of the disease. Many people don't have noticeable symptoms until the cancer has spread.
Dr. Ji Yoon Yoon, a gastroenterologist and an assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York, said the new research could be a 'turning point' for early detection.
'What's very exciting about these findings is, for the first time, localized stomach cancers are the majority of diagnoses in the U.S.,' said Yoon, who was not affiliated with the new study.
Japan and South Korea, which have higher rates of stomach cancer, have screening programs, Yoon said. 'Anybody older than 50 gets screened in Japan, and in South Korea, people aged 40 to 74 get an upper endoscopy every two years.'
Early-stage gastric cancers, when confined to the stomach lining, can often be treated with minimally invasive procedures. In more advanced cases, more extensive surgery is usually required to remove part of the stomach.
The overall five-year survival rate for stomach cancer is around 36%, Yoon said. For people with earlier-stage or localized cancer, the five-year survival rate is 77%.
Dr. Michael Gibson, an associate professor of medicine and the director of translational research for esophagogastric cancer at the Vanderbilt University Medical Center in Nashville, said it's good that it's increasingly being caught early, especially since 'the incidence of gastric cancer is rising in the adolescent and young adult population.'
The new study's data shows that the stage of diagnosis is getting lower within adolescent and young adult groups. While it's not clear why the patients in the study got checked for gastric cancer, it's possible some of the patients were being scanned for other reasons and the stomach cancer was picked up incidentally, he said.
The new findings suggest that more patients may survive stomach cancer because it's being caught early, said Dr. Ryan Moy, a medical oncologist specializing in gastrointestinal cancers at the Columbia University Vagelos College of Physicians and Surgeons in New York.
'However, we will likely need to have longer follow-up to know whether this translates into improvement in survival outcomes,' Gibson said.
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