Gastric cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up.

Although the incidence of gastric cancer is decreasing, there were still 159 900 new cases in Europe in 2006, and 118 200 deaths, representing the fifth highest incidence and fourth highest cause of cancer-related death. The peak incidence is in the seventh decade, and the male:female ratio exceeds 1.5. There is marked geographic variation. Risks include male gender, cigarette smoking, Helicobacter pylori infection, atrophic gastritis, partial gastrectomy, Menetrier’s disease and genetic factors such as hereditary non-polyposis colorectal cancer, familial adenomatous polyposis, hereditary diffuse gastric cancer and Peutz–Jeghers syndrome.