Stomach cancer risk

Preventable cases

Stomach cancer cases are preventable, UK, 2015

 

Caused by infections

Stomach cancer cases caused by infections, UK, 2015

 

Caused by smoking

Stomach cancer cases caused by smoking, UK, 2015

 

Caused by obesity

Stomach cancer cases caused by overweight and obesity, UK, 2015

 

The estimated lifetime risk of being diagnosed with stomach cancer is 1 in 170 (1%) for females, and 1 in 92 (1%) for males born in 1961 in the UK. [1]

These figures take account of the possibility that someone can have more than one diagnosis of stomach cancer in their lifetime ('Adjusted for Multiple Primaries' (AMP) method).[2]

References

  1. Lifetime risk estimates calculated by the Cancer Intelligence Team at Cancer Research UK 2023.
  2. Sasieni PD, Shelton J, Ormiston-Smith N, et al. What is the lifetime risk of developing cancer?: The effect of adjusting for multiple primaries  Br J Cancer, 2011.105(3): p.460-5

    About this data

    Data is for UK, past and projected cancer incidence and mortality and all-cause mortality rates for those born in 1961, ICD-10 C00-C14, C30-C32.

    Calculated by the Cancer Intelligence Team at Cancer Research UK, 2023 (as yet unpublished). Lifetime risk of being diagnosed with cancer for people in the UK born in 1961. Based on method from Ahmad et al. 2015, using projected cancer incidence (using data up to 2018) calculated by the Cancer Intelligence Team at Cancer Research UK and projected all-cause mortality (using data up to 2020, with adjustment for COVID impact) calculated by Office for National Statistics. Differences from previous analyses are attributable mainly to slowing pace of improvement in life expectancy, and also to slowing/stabilising increases in cancer incidence.

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    54% of stomach cancer cases in the UK are preventable.[1]

    Stomach cancer is associated with a number of risk factors.[2-4]

    Stomach Cancer Risk Factors

      Increases risk Decreases risk
    'Sufficient' or 'convincing' evidence
    • Helicobacter pylori (H. pylori)
    • Rubber production
    • Tobacco smoking
    • X-radiation, gamma-radiation
    • Body fatness[a,c]
     
    'Limited' or 'probable' evidence
    • Asbestos (all forms)
    • Epstein-Barr virus (EBV)
    • Inorganic lead compounds
    • Nitrate or nitrite[d]
    • Pickled vegetables (traditional Asian)
    • Processed meat[b]
    • Alcoholic drinks
    • Foods preserved by salting (including salted fish, Chinese-style)
     
    International Agency for Research on Cancer (IARC) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classifications.

    a cardia; b non-cardia; c IARC classifies evidence on body fatness as sufficient, WCRF/AICR classifies evidence on body fatness as probable; d ingested under conditions that result in endogenous nitrosation; e WCRF/AICR classifies evidence on alcoholic drinks as probable.

    See also

    Want to generate bespoke preventable cancers stats statements? Download our interactive statement generator.

    Find out more about the definitions and evidence for this data

    Learn how attributable risk is calculated

    References

    1. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015. British Journal of Cancer 2018. 
    2. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122*. Accessed October 2018.
    3. Lauby-Secretan B, Scoccianti C, Loomis D, et al. Body Fatness and Cancer--Viewpoint of the IARC Working Group. N Engl J Med. 2016 Aug 25;375(8):794-8.
    4. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Findings & Reports. Accessed October 2016.
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    International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] 41% of stomach cancer cases in the UK are caused by H. pylori infection.[2]

    Stomach (non-cardia) cancer risk is 6 times higher in people with H. pylori infection, a pooled analysis showed.[3] This relates to H. pylori status 10+ years prior to stomach cancer diagnosis, which is the most appropriate measure: Negative H. pylori status shortly before stomach cancer diagnosis may reflect infection clearance due to the cancer itself, as H. pylori does not colonise cancer/pre-cancer cells.[3]

    Stomach cancer risk is higher in CagA-positive H. pylori than in CagA-negative H pylori.[4,5

    Stomach cancer risk is 38% lower in asymptomatic infected individuals who receive H. pylori eradication treatment a metanalysis showed.[6] The effect is stronger in areas with a higher baseline stomach cancer incidence rate.[6]

    H. pylori prevalence is falling in the UK, but it remains a problem in developing countries.[2,7,8]

    References

    1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122. Accessed October 2018.
    2. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015. British Journal of Cancer 2018. 
    3. Helicobacter and Cancer Collaborative Group. Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts. Gut 2001;49:347-53.
    4. Palli D, Masala G, Del Giudice G, et al. CagA+ Helicobacter pylori infection and gastric cancer risk in the EPIC-EURGAST study. IJC 2007;120:859-67.
    5. Huang JQ, Zheng GF, Sumanac K, et al. Meta-analysis of the relationship between cagA seropositivity and gastric cancer. Gastroenterology 2003;125:1636-44.
    6. Lee Y, Chiang T, Chou C, et al. Association Between Helicobacter pylori Eradication and Gastric Cancer Incidence: A Systematic Review and Meta-analysis. Gastroenterology 2016;150(5):1113-1124.e5.
    7. Parkin DM. The global health burden of infection-associated cancers in the year 2002. IJC 2006;118:3030-44.
    8. Vyse AJ, Gay NJ, Hesketh LM, et al. The burden of Helicobacter pylori infection in England and Wales. Epidemiol Infect 2002;128:411-7.
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    International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] 15% of stomach cancer cases in the UK are caused by smoking.[2]

    Stomach cancer risk is 62% higher in male smokers compared with male never-smokers, meta-analyses have shown.[3-5] Stomach cancer risk is 20% higher in female smokers compared with female never-smokers, meta-analyses have shown.[3-5]

    Risk is higher in smokers for both cardia and non-cardia stomach cancer,[4] and increases with number of cigarettes smoked per day.[5]

    Stomach cancer risk is not higher in ex-smokers compared with never-smokers.[5

    Smokeless tobacco is not associated with stomach cancer risk.[6,7]

    UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

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    International Agency for Research on Cancer (IARC) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classify the role of this risk factor in cancer development.[1,2] 6% of stomach cancer cases in the UK are caused by overweight and obesity.[3]

    Stomach (cardia) and oesophogaeal adeonocarcinaoma cancer risk is 48% higher in people who are overweight (body mass index [BMI] 25-29.9), and 119% higher in people who are obese (BMI 30+), compared with those of a normal weight (BMI <25), an umbrella review of meta-analyses has shown.[4]

    Stomach cancer risk is 48% higher amongst the highest category of waist circumference compared to the lowest category, a meta-analysis has shown.[5]

    Stomach cancer risk is 33% higher amongst the highest category of waist to hip ratio compared to the lowest category, a meta-analysis has shown,[5] Non-cardia stomach cancer risk is not associated with overweight and obesity, meta-analyses have shown.[4,5]

    UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

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    International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] Around 9% of stomach cancers are EBV-positive, meta-analyses have shown.[2]

    It is unclear how EBV infection is associated with increased stomach cancer risk.[3,4]

    UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

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    International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] 2% of stomach cancer cases in the UK are caused by workplace exposures.[2]

    Asbestos

    Stomach cancer mortality risk is 19% higher in people exposed to asbestos at work, a meta-analysis showed.[3]

    Chromium

    Stomach cancer risk is 27% higher in people exposed to chromium at work, a meta-analysis showed.[4]

    UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

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    International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] Less than 1% of stomach cancer cases in the UK are caused by ionising radiation.[2]

     

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    International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1]

    Stomach cancer risk is not associated with processed meat intake, a meta-analysis of cohort studies showed; though there was some evidence of risk increase in case-control studies.[2]

    Variability between studies may reflect differences by stomach cancer subsite or H. pylori status.[3]

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    International Agency for Research on Cancer (IARC) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classify the role of this risk factor in cancer development.[1,2]

    Pickled food

    Stomach cancer risk is 28-56% higher in people with the highest intake of pickled foods, compared with those with the lowest, meta-analyses have shown.[3,4]

    Total salt intake

    Stomach cancer risk is 68% higher in people with high salt intake compared with those with low salt intake, a meta-analysis showed.[5] Salt intake may increase the extent of H. pylori infection (the association between salt and stomach cancer risk may be limited to people with H. pylori infection[6]) and/or inflame/damage stomach tissue directly.[7] Variability between studies may reflect differences in salt intake assessment or confounding by other components of high-salt foods/diets.[8,9]

    References

    1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122. Accessed October 2018.
    2. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Findings & Reports. Accessed October 2018.
    3. Ren JS, Kamangar F, Forman D, et al. Pickled Food and Risk of Gastric Cancer--a Systematic Review and Meta-analysis of English and Chinese Literature. Cancer Epidemiol Biomarkers Prev 2012.
    4. D'Elia L, Rossi G, Ippolito R, et al. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr. 2012 Aug;31(4):489-98.
    5. Wang XQ, Terry PD, Yan H. Review of salt consumption and stomach cancer risk: epidemiological and biological evidence. World J Gastroenterol 2009;15:2204-13.
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    World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classifies the role of this risk factor in cancer development.[1]

    Stomach cancer risk is 13-21% higher in people who consume ≤ 24g (3+ units) of alcohol per day, compared with non- or occasional drinkers,  meta-analyses have shown;[2,3] however, confounding by smoking or poor diet is possible.[2] Stomach cancer risk is not associated with light or moderate alcohol consumption, meta-analyses have shown.[3]

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    Stomach cancer risk is 44% higher in people with type 1 diabetes compared with people without type 1 diabetes, a meta-analysis of mainly European populations has shown.[1] However, little or no increase in stomach cancer risk was found in diabetics (combining both people with type 1 and type 2 diabetes) a meta-analysis showed.[3]Stomach cancer risk among diabetics may be lower in metformin users compared with non-users, a meta-analysis of cohort studies showed; however meta-analysis of randomised control trials (RCTs) showed no association.[3]

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    Acknowledgements

    We are grateful to the many organisations across the UK which collect, analyse, and share the data which we use, and to the patients and public who consent for their data to be used. Find out more about the sources which are essential for our statistics.