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KMID : 0603520000050020101
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Journal of Korean Association of Cancer Prevention
2000 Volume.5 No. 2 p.101 ~ p.112
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Chemoprevention of Stomach Cancer
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Hong Weon-Seon
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Abstract
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Gastric cancer is the most common cancer in Korea, with the life-time risk being estimated at 7∼8% and 3% in Korean male and female, respectively. Chemoprevention is to intervene the early stage of carcinogenesis, promotion or progression, to prevent initiated cells from developing clinical cancer, as initiated cells accumulated in the body are not effectively eliminated or reversed by the current chemopreventive approaches. Intake of N-nitroso compounds, heterocyclic amines and salt or Helicobacter pylori (H.pylori) infection increases the risk for stomach cancer, while the consumption of large amout of fresh fruits, vegetables and cereals is associated with a reduced risk. β -carotene, vitamin C and vitamin E are believed to be the potential anticarcinogenic substances in fruits and vegetables. However, epidemiologic studies on these substances have yielded conflicting results, although numerous in vitro and in vivo animal experiments have shown the significant preventive activity against stomach cancer. On the other hand, the recent advent of H. pylori, group 1 carcinogen for human stomach cancer, makes the previous studies difficult to interpret. There is strong evidence that most of stomach cancers develop from the mucosae with chronic active gastritis which progresses through atrophy, intestinal metaplasia and dysplasia. Numerous studies have demonstrated that H. pylori infection leads to approximately 2-fold increased risk for stomach cancer in persons with less than 10 years of the infection. In persons with 10∼14 years and more than 15 years, H. pylori infection increases the risk 4-5- and 8-9-fold, respectively. A lot of evidences have been accumulated so far that the eradication reduces the overall risk for stomach cancer. However, it is still unclear when the adequate time for eradication to prevent stomach cancer is. It is of great importance that the eradication should be done before the certain genetic change develops. The efficacy of H. pylori eradication for the chemoprevention is being examined in several large-scale intervention studies in several countries. Those studies will provide the answer to the cost-benefit effect of the eradication on preventing stomach cancer.
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KEYWORD
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Stomach cancer, Chemoprevention, Diet, H. pylori
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