Upper GI & Hepatobiliary SurgeryPending review

Gastric Cancer

Chronic Helicobacter pylori infection drives atrophic gastritis and intestinal metaplasia, and it is this field of pre-malignant change accumulating over years (not a single event) that eventually gives rise to adenocarcinoma, which is why early disease is silent and presentation is often late.

In a nutshell

Chronic H. pylori-driven inflammation progresses through atrophic gastritis and intestinal metaplasia to adenocarcinoma (the Correa cascade), and because the stomach can absorb early tumour growth without symptoms, gastric cancer typically presents late with alarm features rather than early dyspepsia alone.

Classic presentation

Vague dyspepsia and early satiety progressing to weight loss and iron-deficiency anaemia, sometimes with vomiting from outlet obstruction, in a patient with chronic H. pylori infection.

Key points

The Correa cascade (chronic gastritis, atrophic gastritis, intestinal metaplasia, dysplasia, adenocarcinoma) is the mechanistic backbone of most gastric cancer.

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Educational content pending clinical review. Not medical advice.