Gastric cancer refers to malignancies that originate in the stomach lining. The most common type is adenocarcinoma, accounting for the majority of cases.
In Uganda, gastric cancer has become a leading cause of cancer-related morbidity and mortality, with an estimated 7.5 percent of all cancer cases attributed to this disease. The incidence has notably increased in regions such as Kigezi and Ankole in southwestern Uganda, where dietary habits may contribute to the rising numbers.
Several factors contribute to the development of gastric cancer in Uganda: Helicobacter pylori infection: Chronic infection with Helicobacter pylori is a well-established risk factor for gastric cancer. In Uganda, studies have shown a high prevalence of this bacterium among patients with stomach cancer, suggesting a significant role in the disease’s etiology. Dietary habits: Consumption of a diet rich in salty, smoked, or pickled foods has been linked to an increased risk of gastric cancer.
In southwestern Uganda, where such dietary practices are prevalent, the incidence of gastric cancer is notably higher. Tobacco and alcohol use: Smoking and excessive alcohol consumption are recognised risk factors for various cancers, including gastric cancer.
In Uganda, the prevalence of tobacco use and harmful alcohol consumption varies by region, with certain areas exhibiting higher rates.
Genetic factors: A family history of gastric cancer can increase an individual’s risk. Additionally, genetic mutations and conditions such as blood group O+ have been associated with a higher susceptibility to the disease. Age and gender: Gastric cancer is more common in individuals over the age of 50, with a higher incidence in males compared to females.
Prevention
Preventing gastric cancer involves addressing its underlying risk factors through several key strategies. One of the most effective measures is the eradication of Helicobacter pylori.
Public health initiatives that promote improved sanitation, hygiene, and access to medical treatment are crucial for reducing H. pylori infections and, in turn, lowering the risk of gastric cancer. Dietary modifications also play a significant role. Encouraging the consumption of a balanced diet rich in fruits, vegetables, and whole grains, while limiting salty, smoked, and pickled foods, can greatly reduce gastric cancer risk.
Controlling tobacco and alcohol use is another critical preventive approach. Implementing policies to curb tobacco use and harmful alcohol consumption, supported by public education campaigns, can contribute to a decline in gastric cancer incidence.
For individuals at high risk, such as those with a family history of gastric cancer or persistent gastrointestinal symptoms, regular screening and early detection are vital. These measures significantly improve the chances of successful treatment and better outcomes.
Treatment Options at UCI
The Uganda Cancer Institute (UCI) offers a range of treatment modalities for gastric cancer. Chemotherapy, which uses drugs to kill or inhibit the growth of cancer cells, is available and may be administered alone or in combination with other therapies.
Surgical interventions are considered when the tumour is localised. Procedures such aspartial or total gastrectomy (removal of part or all of the stomach) may be performed.
However, due to the common occurrence of late-stage diagnosis, surgery is often not a viable option. For patients with advanced gastric cancer, palliative care is a core component of treatment. This approach focuses on relieving symptoms and enhancing quality of life, including pain management and emotional and psychological support.
The writer, Dr Jackson Orem, is the executive director, Uganda Cancer Institute.
