GITNUXREPORT 2026

Stomach Cancer Statistics

Stomach cancer remains a global health burden despite declining incidence rates in many countries.

Written by Elif Demirci·Edited by Abigail Foster·Fact-checked by Astrid Bergmann

Published Feb 13, 2026·Last verified Apr 2, 2026·Next review: Oct 2026

How We Build This Report

Primary Source Collection

Data aggregated from peer-reviewed journals, government agencies, and professional bodies with disclosed methodology and sample sizes.

Editorial Curation

Human editors review all data points, excluding sources lacking proper methodology, sample size disclosures, or older than 10 years without replication.

AI-Powered Verification

Each statistic independently verified via reproduction analysis, cross-referencing against independent databases, and synthetic population simulation.

Human Cross-Check

Final human editorial review of all AI-verified statistics. Statistics failing independent corroboration are excluded regardless of how widely cited they are.

Statistics that could not be independently verified are excluded regardless of how widely cited they are elsewhere.

Our process →

Statistic 1

Early satiety occurs in 60-80% of advanced stomach cancer patients at diagnosis

Statistic 2

Unintentional weight loss >10% body weight in 3 months seen in 60% of symptomatic cases

Statistic 3

Epigastric pain or discomfort reported by 50-70% of patients prior to diagnosis

Statistic 4

Iron deficiency anemia (microcytic) present in 40-60% due to chronic blood loss

Statistic 5

Dysphagia more common in cardia tumors (30-50% of proximal cases)

Statistic 6

Nausea and vomiting occur in 40% of patients, often with gastric outlet obstruction

Statistic 7

Melena or hematemesis in 20-30% at presentation from ulcerated lesions

Statistic 8

Palpable epigastric mass in <10% of cases, usually advanced disease

Statistic 9

Ascites from peritoneal carcinomatosis in 10-20% of stage IV patients

Statistic 10

Paraneoplastic syndromes like acanthosis nigricans in 1-2% of cases

Statistic 11

Upper GI endoscopy detects 95% of stomach cancers, gold standard for diagnosis

Statistic 12

Biopsy confirmation rate >95% on first endoscopy in suspicious lesions

Statistic 13

Serum pepsinogen I/II ratio <3 indicates atrophic gastritis, 80% sensitivity for high-risk precursors

Statistic 14

Fecal occult blood test positive in 70-80% of symptomatic cancers

Statistic 15

Virchow's node (left supraclavicular) palpable in 5-10% of metastatic cases

Statistic 16

Sister Mary Joseph's nodule (umbilical) in 1-5% of peritoneal spread cases

Statistic 17

Dyspepsia refractory to PPI in >45 years prompts endoscopy, 2-5% yield for cancer

Statistic 18

CT scan shows wall thickening >1cm in 85% of advanced tumors

Statistic 19

Barium meal sensitivity 50-70% for linitis plastica subtype

Statistic 20

HER2 overexpression in 10-20% of gastric adenocarcinomas, tested by IHC/FISH

Statistic 21

PD-L1 expression ≥1% in 40-50% of tumors, prognostic biomarker

Statistic 22

Lauren diffuse type presents earlier with 80% stage III/IV vs. 60% intestinal

Statistic 23

Signet-ring cell histology in 15-20% globally, worse prognosis

Statistic 24

EUS staging accuracy 70-90% for T stage, 50-70% for N stage

Statistic 25

PET-CT detects metastases with 80% sensitivity in stage IV

Statistic 26

Diagnostic delay >3 months in 40% of symptomatic patients in low-resource settings

Statistic 27

Abdominal bloating post-meals in 30-50% pre-diagnosis

Statistic 28

Jaundice from lymph node obstruction rare, <5%

Statistic 29

70% of patients have stage III/IV at diagnosis globally

Statistic 30

In 2020, stomach cancer was the fifth most common malignancy worldwide, with 1,089,103 new cases reported globally according to GLOBOCAN estimates

Statistic 31

The age-standardized incidence rate (ASIR) for stomach cancer in men worldwide was 18.0 per 100,000 in 2020, significantly higher than in women at 8.8 per 100,000

Statistic 32

Eastern Asia had the highest ASIR for stomach cancer at 32.5 per 100,000 in men in 2020, accounting for over 50% of global cases despite comprising only 22% of the world population

Statistic 33

In the United States, there were 26,380 new cases of stomach cancer estimated for 2023, with 10,990 deaths projected

Statistic 34

The lifetime risk of developing stomach cancer is about 0.8% (1 in 125) for American men and 0.4% (1 in 256) for women

Statistic 35

SEER data from 2017-2021 shows the incidence rate of stomach cancer in the US at 6.8 per 100,000 for all races and both sexes combined

Statistic 36

Among US racial/ethnic groups, non-Hispanic Black individuals have the highest stomach cancer incidence rate at 8.2 per 100,000 (2017-2021)

Statistic 37

Stomach cancer incidence in the US has been declining by about 1.5% per year from 2012-2021

Statistic 38

In Japan, the ASIR for stomach cancer was 27.5 per 100,000 in men in 2020, reflecting high historical rates due to screening programs

Statistic 39

Mongolia reports the world's highest ASIR for stomach cancer at 33.1 per 100,000 overall in 2020

Statistic 40

Globally, stomach cancer ranks fourth in cancer mortality with 769,000 deaths in 2020

Statistic 41

In Europe, the ASIR for stomach cancer decreased from 20.5 per 100,000 in men in 1990 to 12.6 in 2020

Statistic 42

US males aged 65-74 have the highest stomach cancer incidence rate at 25.3 per 100,000 (2017-2021 SEER data)

Statistic 43

Stomach cancer accounts for 1.5% of all new cancer cases in the US (2023 estimate)

Statistic 44

In South Korea, nationwide screening has reduced stomach cancer mortality by 40% since 2000, with ASIR at 19.7 per 100,000 in men in 2020

Statistic 45

Global prevalence of stomach cancer (5-year) was estimated at 1.25 million cases in 2020

Statistic 46

In China, 478,508 new stomach cancer cases were reported in 2020, representing 44% of global cases

Statistic 47

Stomach cancer incidence among US Hispanics is 11.7 per 100,000 (2017-2021), higher than non-Hispanic whites at 5.4

Statistic 48

The median age at stomach cancer diagnosis in the US is 68 years (SEER 2017-2021)

Statistic 49

In high-risk areas like the Japanese Prefecture of Niigata, ASIR was 50.5 per 100,000 in men pre-screening era, now reduced

Statistic 50

Worldwide, 80-90% of stomach cancers are adenocarcinomas, with diffuse and intestinal subtypes varying by region

Statistic 51

In the UK, stomach cancer incidence has fallen by 70% since the 1970s, with 9,325 cases in 2019

Statistic 52

Australian stomach cancer ASIR is 5.2 per 100,000 in men (2020), low due to diet and H. pylori eradication

Statistic 53

In Brazil, Northeast region has ASIR of 15.8 per 100,000 for stomach cancer, linked to socioeconomic factors

Statistic 54

Global DALYs lost to stomach cancer in 2019 were 11.1 million, primarily in Eastern Asia

Statistic 55

US Native American/Alaska Native population has stomach cancer incidence of 13.1 per 100,000 (2017-2021)

Statistic 56

Stomach cancer is more common in lower socioeconomic groups, with 2-fold higher incidence in deprived UK areas

Statistic 57

In 2022, EU-27 countries reported 66,662 new stomach cancer cases

Statistic 58

Incidence of cardia subtype increasing in Western countries by 2-4% annually, while non-cardia declining

Statistic 59

In India, ASIR for stomach cancer is 3.6 per 100,000 overall, but rising in urban areas

Statistic 60

Global cumulative risk of developing stomach cancer by age 75 is 2.2% for men and 1.0% for women (2020)

Statistic 61

5-year OS after curative resection: stage I 70-90%, stage II 40-60%, stage III 20-30%

Statistic 62

Localized stomach cancer 5-year relative survival 75% (US SEER 2013-2019)

Statistic 63

Regional spread survival drops to 36%, distant metastasis 7%

Statistic 64

Overall 5-year survival 36.3% in US (improved from 22% in 1975)

Statistic 65

Stage IA complete response to ESD 98%, 5-year survival >95%

Statistic 66

MSI-H tumors have 5-year OS 70% vs. 45% MSS in stage II/III adjuvant

Statistic 67

Peritoneal metastasis median survival 6-12 months despite treatment

Statistic 68

Signet-ring cell carcinoma 5-year survival 25% vs. 45% adenocarcinoma

Statistic 69

Lymphovascular invasion halves 5-year survival (HR 2.1)

Statistic 70

Negative margins (R0) vs. R1: 5-year OS 55% vs. 30%

Statistic 71

HER2+ tumors without trastuzumab OS 12 months median advanced

Statistic 72

Lauren intestinal type better prognosis than diffuse (HR 0.75)

Statistic 73

Postoperative complications increase mortality risk 2-fold (HR 1.9)

Statistic 74

Elderly (>75) 5-year survival 20% vs. 45% <65 after resection

Statistic 75

N3 nodal involvement 5-year OS <20%

Statistic 76

EBV-associated gastric cancer better prognosis (HR 0.72 for survival)

Statistic 77

Median OS refractory disease 4 months historical, improved to 8-11 with immunotherapy

Statistic 78

T4 tumors 5-year survival 25% vs. 60% T1-2

Statistic 79

Adjuvant therapy benefit largest in node-positive (absolute 10-15%)

Statistic 80

Global median survival advanced unresectable 10 months with chemo

Statistic 81

pTNM stage prognostic accuracy 75-80%

Statistic 82

High tumor mutational burden (>10 mut/Mb) predicts immunotherapy response, OS doubled

Statistic 83

Male sex worse prognosis (HR 1.2)

Statistic 84

Cardia location survival similar to esophageal (worse than body)

Statistic 85

Helicobacter pylori infection increases stomach cancer risk by 5.6-fold (95% CI 3.7-8.6) in meta-analysis of 12 studies

Statistic 86

Chronic H. pylori infection is classified as a Group 1 carcinogen by IARC, responsible for 89% of non-cardia stomach cancers

Statistic 87

Smoking doubles the risk of stomach cancer (RR 1.92, 95% CI 1.46-2.53) in never-smokers' adjusted meta-analysis

Statistic 88

High salt intake (>5g/day) associated with 12% increased risk per 1g increment (meta-analysis of 37 studies)

Statistic 89

Obesity (BMI ≥30) increases cardia stomach cancer risk by 82% in men (RR 1.82, 95% CI 1.20-2.77)

Statistic 90

Family history of stomach cancer raises risk 2-3 fold, with first-degree relatives having OR 2.02 (95% CI 1.20-3.41)

Statistic 91

Pernicious anemia increases stomach cancer risk 3.5-fold (SIR 3.57, 95% CI 2.68-4.63) in Swedish cohort

Statistic 92

Processed meat consumption linked to 18% higher risk per 50g/day (RR 1.18, 95% CI 1.09-1.28), WHO/IARC evaluation

Statistic 93

Alcohol intake >45g/day increases risk by 1.3-fold for non-cardia subtype (meta-analysis)

Statistic 94

Epstein-Barr virus (EBV) associated with 8.7-10% of gastric cancers, particularly lymphoepithelioma-like type

Statistic 95

Atrophic gastritis from H. pylori leads to 0.5-1% annual risk of gastric cancer progression

Statistic 96

Blood type A individuals have 20% higher risk (OR 1.20, 95% CI 1.10-1.31) vs. type O, meta-analysis

Statistic 97

Low intake of fruits and vegetables (<300g/day) increases risk by 20-50%, dose-response meta-analysis

Statistic 98

Gastroesophageal reflux disease (GERD) triples cardia cancer risk (OR 3.0, 95% CI 1.5-6.0)

Statistic 99

Ménétrier's disease carries 10-15% lifetime risk of adenocarcinoma development

Statistic 100

Occupational exposure to coal dust and asbestos increases risk 1.5-2 fold in cohort studies

Statistic 101

Diabetes mellitus associated with 20% increased risk (SRR 1.22, 95% CI 1.13-1.32), meta-analysis of 25 studies

Statistic 102

H. pylori cagA-positive strains elevate risk 2.5-fold compared to cagA-negative (OR 2.58)

Statistic 103

Pickled vegetable consumption common in high-risk areas, RR 1.5 per frequent serving

Statistic 104

Radiation exposure (e.g., Hiroshima survivors) increases risk 2-6 fold depending on dose

Statistic 105

Chronic NSAID use reduces stomach cancer risk by 32% (OR 0.68, 95% CI 0.58-0.80)

Statistic 106

Polymorphisms in IL-1β gene increase risk 2-3 fold in H. pylori infected individuals

Statistic 107

Male gender doubles risk compared to females (RR 2.0), consistent across global studies

Statistic 108

Age >60 years carries 10-fold higher incidence than <40 years

Statistic 109

Smoked meat intake associated with OR 1.34 (95% CI 1.12-1.60) per weekly serving

Statistic 110

Partial gastrectomy for benign disease increases cancer risk 3-5 fold after 15+ years

Statistic 111

Vitamin C deficiency exacerbates H. pylori-induced risk, protective at >150mg/day intake

Statistic 112

Neoadjuvant chemotherapy (FLOT regimen) improves R0 resection rate to 85% from 65% surgery alone in locally advanced

Statistic 113

Perioperative ECF (epirubicin, cisplatin, 5-FU) increases 5-year survival to 36% vs. 23% surgery alone (MAGIC trial)

Statistic 114

Trastuzumab added to chemotherapy doubles response rate to 47% in HER2+ advanced gastric cancer (ToGA trial)

Statistic 115

Ramucirumab monotherapy PFS 2.3 months vs. 1.3 placebo in refractory disease (RAINBOW)

Statistic 116

D2 lymphadenectomy standard, harvesting ≥15 nodes improves survival by 10-15%

Statistic 117

Adjuvant S-1 chemotherapy in Asia yields 5-year OS 71.7% vs. 61% surgery (ACTS-GC)

Statistic 118

Pembrolizumab ORR 60% (95% CI 49-70) in MSI-H/dMMR advanced gastric cancer (KEYNOTE-158)

Statistic 119

Total gastrectomy with Roux-en-Y in proximal tumors, 5-year survival 50-70% if stage I

Statistic 120

HIPEC (hyperthermic intraperitoneal chemo) reduces peritoneal recurrence by 20% in select cases

Statistic 121

Nivolumab + chemo improves OS to 13.8 months vs. 11.6 placebo arm (ATTRACTION-4 Japan)

Statistic 122

CAPOX (capecitabine+oxaliplatin) non-inferior to FOLFOX, used in 60% adjuvant regimens

Statistic 123

Endoscopic submucosal dissection (ESD) curative in 90-95% T1a intramucosal cancers <2cm

Statistic 124

Radiation dose 45 Gy with concurrent chemo for unresectable, local control 50-60%

Statistic 125

Regorafenib OS 5.8 vs. 4.5 months placebo in refractory (INTEGRATE)

Statistic 126

Gastrectomy morbidity 20-40%, mortality <5% in high-volume centers (>20/year)

Statistic 127

Irinotecan-based second-line therapy PFS 4 months median

Statistic 128

CLARITY trial: FLOT superior to ECX, pCR 16% vs. 7%

Statistic 129

Proton therapy reduces cardiac dose by 50% vs. IMRT in gastric RT

Statistic 130

Zolbetuximab + chemo ORR 37% in CLDN18.2+ (SPOTLIGHT trial)

Statistic 131

Palliative stent for GOO relieves symptoms in 80-90% within 24h

Statistic 132

Adjuvant CAPOX OS benefit 7% absolute at 3 years (CLASSIC trial Korea)

Statistic 133

5-FU/leucovorin + cisplatin response 41% in metastatic (meta-analysis)

Statistic 134

Robotic gastrectomy reduces blood loss 200ml vs. laparoscopic, equivalent oncologic outcomes

Statistic 135

Avelumab maintenance OS 14.4 vs. 11.1 months post-FLX (JAVELIN)

Statistic 136

H. pylori eradication post-resection reduces metachronous cancer by 50% (MALT trial)

Statistic 137

FOLFIRI second-line OS 6.9 months (meta-analysis 10 trials)

1/137

Sources

Trusted by 500+ publications

+497

Hidden in plain sight as a leading global killer, stomach cancer claimed over a million lives in 2020 alone, presenting a complex health challenge that varies dramatically by geography, genetics, and lifestyle.

Key Takeaways

In 2020, stomach cancer was the fifth most common malignancy worldwide, with 1,089,103 new cases reported globally according to GLOBOCAN estimates
The age-standardized incidence rate (ASIR) for stomach cancer in men worldwide was 18.0 per 100,000 in 2020, significantly higher than in women at 8.8 per 100,000
Eastern Asia had the highest ASIR for stomach cancer at 32.5 per 100,000 in men in 2020, accounting for over 50% of global cases despite comprising only 22% of the world population
Helicobacter pylori infection increases stomach cancer risk by 5.6-fold (95% CI 3.7-8.6) in meta-analysis of 12 studies
Chronic H. pylori infection is classified as a Group 1 carcinogen by IARC, responsible for 89% of non-cardia stomach cancers
Smoking doubles the risk of stomach cancer (RR 1.92, 95% CI 1.46-2.53) in never-smokers' adjusted meta-analysis
Early satiety occurs in 60-80% of advanced stomach cancer patients at diagnosis
Unintentional weight loss >10% body weight in 3 months seen in 60% of symptomatic cases
Epigastric pain or discomfort reported by 50-70% of patients prior to diagnosis
Neoadjuvant chemotherapy (FLOT regimen) improves R0 resection rate to 85% from 65% surgery alone in locally advanced
Perioperative ECF (epirubicin, cisplatin, 5-FU) increases 5-year survival to 36% vs. 23% surgery alone (MAGIC trial)
Trastuzumab added to chemotherapy doubles response rate to 47% in HER2+ advanced gastric cancer (ToGA trial)
5-year OS after curative resection: stage I 70-90%, stage II 40-60%, stage III 20-30%
Localized stomach cancer 5-year relative survival 75% (US SEER 2013-2019)
Regional spread survival drops to 36%, distant metastasis 7%

Stomach cancer remains a global health burden despite declining incidence rates in many countries.

Clinical Presentation

1Early satiety occurs in 60-80% of advanced stomach cancer patients at diagnosis

Verified

2Unintentional weight loss >10% body weight in 3 months seen in 60% of symptomatic cases

Verified

3Epigastric pain or discomfort reported by 50-70% of patients prior to diagnosis

Verified

4Iron deficiency anemia (microcytic) present in 40-60% due to chronic blood loss

Directional

5Dysphagia more common in cardia tumors (30-50% of proximal cases)

Single source

6Nausea and vomiting occur in 40% of patients, often with gastric outlet obstruction

Verified

7Melena or hematemesis in 20-30% at presentation from ulcerated lesions

Verified

8Palpable epigastric mass in <10% of cases, usually advanced disease

Verified

9Ascites from peritoneal carcinomatosis in 10-20% of stage IV patients

Directional

10Paraneoplastic syndromes like acanthosis nigricans in 1-2% of cases

Single source

11Upper GI endoscopy detects 95% of stomach cancers, gold standard for diagnosis

Verified

12Biopsy confirmation rate >95% on first endoscopy in suspicious lesions

Verified

13Serum pepsinogen I/II ratio <3 indicates atrophic gastritis, 80% sensitivity for high-risk precursors

Verified

14Fecal occult blood test positive in 70-80% of symptomatic cancers

Directional

15Virchow's node (left supraclavicular) palpable in 5-10% of metastatic cases

Single source

16Sister Mary Joseph's nodule (umbilical) in 1-5% of peritoneal spread cases

Verified

17Dyspepsia refractory to PPI in >45 years prompts endoscopy, 2-5% yield for cancer

Verified

18CT scan shows wall thickening >1cm in 85% of advanced tumors

Verified

19Barium meal sensitivity 50-70% for linitis plastica subtype

Directional

20HER2 overexpression in 10-20% of gastric adenocarcinomas, tested by IHC/FISH

Single source

21PD-L1 expression ≥1% in 40-50% of tumors, prognostic biomarker

Verified

22Lauren diffuse type presents earlier with 80% stage III/IV vs. 60% intestinal

Verified

23Signet-ring cell histology in 15-20% globally, worse prognosis

Verified

24EUS staging accuracy 70-90% for T stage, 50-70% for N stage

Directional

25PET-CT detects metastases with 80% sensitivity in stage IV

Single source

26Diagnostic delay >3 months in 40% of symptomatic patients in low-resource settings

Verified

27Abdominal bloating post-meals in 30-50% pre-diagnosis

Verified

28Jaundice from lymph node obstruction rare, <5%

Verified

2970% of patients have stage III/IV at diagnosis globally

Directional

Clinical Presentation Interpretation

The unsettling menu of stomach cancer—where early fullness, unexplained weight loss, and nagging pain are the unignorable opening acts for a disease that, in 70% of patients, has already taken a devastating final bow by the time the curtain is raised at diagnosis.

Epidemiology

1In 2020, stomach cancer was the fifth most common malignancy worldwide, with 1,089,103 new cases reported globally according to GLOBOCAN estimates

Verified

2The age-standardized incidence rate (ASIR) for stomach cancer in men worldwide was 18.0 per 100,000 in 2020, significantly higher than in women at 8.8 per 100,000

Verified

3Eastern Asia had the highest ASIR for stomach cancer at 32.5 per 100,000 in men in 2020, accounting for over 50% of global cases despite comprising only 22% of the world population

Verified

4In the United States, there were 26,380 new cases of stomach cancer estimated for 2023, with 10,990 deaths projected

Directional

5The lifetime risk of developing stomach cancer is about 0.8% (1 in 125) for American men and 0.4% (1 in 256) for women

Single source

6SEER data from 2017-2021 shows the incidence rate of stomach cancer in the US at 6.8 per 100,000 for all races and both sexes combined

Verified

7Among US racial/ethnic groups, non-Hispanic Black individuals have the highest stomach cancer incidence rate at 8.2 per 100,000 (2017-2021)

Verified

8Stomach cancer incidence in the US has been declining by about 1.5% per year from 2012-2021

Verified

9In Japan, the ASIR for stomach cancer was 27.5 per 100,000 in men in 2020, reflecting high historical rates due to screening programs

Directional

10Mongolia reports the world's highest ASIR for stomach cancer at 33.1 per 100,000 overall in 2020

Single source

11Globally, stomach cancer ranks fourth in cancer mortality with 769,000 deaths in 2020

Verified

12In Europe, the ASIR for stomach cancer decreased from 20.5 per 100,000 in men in 1990 to 12.6 in 2020

Verified

13US males aged 65-74 have the highest stomach cancer incidence rate at 25.3 per 100,000 (2017-2021 SEER data)

Verified

14Stomach cancer accounts for 1.5% of all new cancer cases in the US (2023 estimate)

Directional

15In South Korea, nationwide screening has reduced stomach cancer mortality by 40% since 2000, with ASIR at 19.7 per 100,000 in men in 2020

Single source

16Global prevalence of stomach cancer (5-year) was estimated at 1.25 million cases in 2020

Verified

17In China, 478,508 new stomach cancer cases were reported in 2020, representing 44% of global cases

Verified

18Stomach cancer incidence among US Hispanics is 11.7 per 100,000 (2017-2021), higher than non-Hispanic whites at 5.4

Verified

19The median age at stomach cancer diagnosis in the US is 68 years (SEER 2017-2021)

Directional

20In high-risk areas like the Japanese Prefecture of Niigata, ASIR was 50.5 per 100,000 in men pre-screening era, now reduced

Single source

21Worldwide, 80-90% of stomach cancers are adenocarcinomas, with diffuse and intestinal subtypes varying by region

Verified

22In the UK, stomach cancer incidence has fallen by 70% since the 1970s, with 9,325 cases in 2019

Verified

23Australian stomach cancer ASIR is 5.2 per 100,000 in men (2020), low due to diet and H. pylori eradication

Verified

24In Brazil, Northeast region has ASIR of 15.8 per 100,000 for stomach cancer, linked to socioeconomic factors

Directional

25Global DALYs lost to stomach cancer in 2019 were 11.1 million, primarily in Eastern Asia

Single source

26US Native American/Alaska Native population has stomach cancer incidence of 13.1 per 100,000 (2017-2021)

Verified

27Stomach cancer is more common in lower socioeconomic groups, with 2-fold higher incidence in deprived UK areas

Verified

28In 2022, EU-27 countries reported 66,662 new stomach cancer cases

Verified

29Incidence of cardia subtype increasing in Western countries by 2-4% annually, while non-cardia declining

Directional

30In India, ASIR for stomach cancer is 3.6 per 100,000 overall, but rising in urban areas

Single source

31Global cumulative risk of developing stomach cancer by age 75 is 2.2% for men and 1.0% for women (2020)

Verified

Epidemiology Interpretation

Despite its global decline, stomach cancer remains a stealthy threat, stubbornly prevalent in Eastern Asia and disproportionately lethal to men, the elderly, and marginalized communities worldwide, proving geography and circumstance are still bitter ingredients in this disease.

Prognosis

15-year OS after curative resection: stage I 70-90%, stage II 40-60%, stage III 20-30%

Verified

2Localized stomach cancer 5-year relative survival 75% (US SEER 2013-2019)

Verified

3Regional spread survival drops to 36%, distant metastasis 7%

Verified

4Overall 5-year survival 36.3% in US (improved from 22% in 1975)

Directional

5Stage IA complete response to ESD 98%, 5-year survival >95%

Single source

6MSI-H tumors have 5-year OS 70% vs. 45% MSS in stage II/III adjuvant

Verified

7Peritoneal metastasis median survival 6-12 months despite treatment

Verified

8Signet-ring cell carcinoma 5-year survival 25% vs. 45% adenocarcinoma

Verified

9Lymphovascular invasion halves 5-year survival (HR 2.1)

Directional

10Negative margins (R0) vs. R1: 5-year OS 55% vs. 30%

Single source

11HER2+ tumors without trastuzumab OS 12 months median advanced

Verified

12Lauren intestinal type better prognosis than diffuse (HR 0.75)

Verified

13Postoperative complications increase mortality risk 2-fold (HR 1.9)

Verified

14Elderly (>75) 5-year survival 20% vs. 45% <65 after resection

Directional

15N3 nodal involvement 5-year OS <20%

Single source

16EBV-associated gastric cancer better prognosis (HR 0.72 for survival)

Verified

17Median OS refractory disease 4 months historical, improved to 8-11 with immunotherapy

Verified

18T4 tumors 5-year survival 25% vs. 60% T1-2

Verified

19Adjuvant therapy benefit largest in node-positive (absolute 10-15%)

Directional

20Global median survival advanced unresectable 10 months with chemo

Single source

21pTNM stage prognostic accuracy 75-80%

Verified

22High tumor mutational burden (>10 mut/Mb) predicts immunotherapy response, OS doubled

Verified

23Male sex worse prognosis (HR 1.2)

Verified

24Cardia location survival similar to esophageal (worse than body)

Directional

Prognosis Interpretation

The brutal, stage-by-stage reality of stomach cancer survival—where a single millimeter of margin, a positive node, or a rare molecular subtype can swing your odds from a coin flip to a death sentence—reminds us that in this war, the battleground is microscopic, but the stakes could not be more vast.

Risk Factors

1Helicobacter pylori infection increases stomach cancer risk by 5.6-fold (95% CI 3.7-8.6) in meta-analysis of 12 studies

Verified

2Chronic H. pylori infection is classified as a Group 1 carcinogen by IARC, responsible for 89% of non-cardia stomach cancers

Verified

3Smoking doubles the risk of stomach cancer (RR 1.92, 95% CI 1.46-2.53) in never-smokers' adjusted meta-analysis

Verified

4High salt intake (>5g/day) associated with 12% increased risk per 1g increment (meta-analysis of 37 studies)

Directional

5Obesity (BMI ≥30) increases cardia stomach cancer risk by 82% in men (RR 1.82, 95% CI 1.20-2.77)

Single source

6Family history of stomach cancer raises risk 2-3 fold, with first-degree relatives having OR 2.02 (95% CI 1.20-3.41)

Verified

7Pernicious anemia increases stomach cancer risk 3.5-fold (SIR 3.57, 95% CI 2.68-4.63) in Swedish cohort

Verified

8Processed meat consumption linked to 18% higher risk per 50g/day (RR 1.18, 95% CI 1.09-1.28), WHO/IARC evaluation

Verified

9Alcohol intake >45g/day increases risk by 1.3-fold for non-cardia subtype (meta-analysis)

Directional

10Epstein-Barr virus (EBV) associated with 8.7-10% of gastric cancers, particularly lymphoepithelioma-like type

Single source

11Atrophic gastritis from H. pylori leads to 0.5-1% annual risk of gastric cancer progression

Verified

12Blood type A individuals have 20% higher risk (OR 1.20, 95% CI 1.10-1.31) vs. type O, meta-analysis

Verified

13Low intake of fruits and vegetables (<300g/day) increases risk by 20-50%, dose-response meta-analysis

Verified

14Gastroesophageal reflux disease (GERD) triples cardia cancer risk (OR 3.0, 95% CI 1.5-6.0)

Directional

15Ménétrier's disease carries 10-15% lifetime risk of adenocarcinoma development

Single source

16Occupational exposure to coal dust and asbestos increases risk 1.5-2 fold in cohort studies

Verified

17Diabetes mellitus associated with 20% increased risk (SRR 1.22, 95% CI 1.13-1.32), meta-analysis of 25 studies

Verified

18H. pylori cagA-positive strains elevate risk 2.5-fold compared to cagA-negative (OR 2.58)

Verified

19Pickled vegetable consumption common in high-risk areas, RR 1.5 per frequent serving

Directional

20Radiation exposure (e.g., Hiroshima survivors) increases risk 2-6 fold depending on dose

Single source

21Chronic NSAID use reduces stomach cancer risk by 32% (OR 0.68, 95% CI 0.58-0.80)

Verified

22Polymorphisms in IL-1β gene increase risk 2-3 fold in H. pylori infected individuals

Verified

23Male gender doubles risk compared to females (RR 2.0), consistent across global studies

Verified

24Age >60 years carries 10-fold higher incidence than <40 years

Directional

25Smoked meat intake associated with OR 1.34 (95% CI 1.12-1.60) per weekly serving

Single source

26Partial gastrectomy for benign disease increases cancer risk 3-5 fold after 15+ years

Verified

27Vitamin C deficiency exacerbates H. pylori-induced risk, protective at >150mg/day intake

Verified

Risk Factors Interpretation

If you wanted to design a perfect storm for stomach cancer, you'd start with a chronic Helicobacter pylori infection, marinate it in salty processed foods, add a dash of smoking and family history, and then systematically avoid fruits, vegetables, and possibly aspirin.

Treatment

1Neoadjuvant chemotherapy (FLOT regimen) improves R0 resection rate to 85% from 65% surgery alone in locally advanced

Verified

2Perioperative ECF (epirubicin, cisplatin, 5-FU) increases 5-year survival to 36% vs. 23% surgery alone (MAGIC trial)

Verified

3Trastuzumab added to chemotherapy doubles response rate to 47% in HER2+ advanced gastric cancer (ToGA trial)

Verified

4Ramucirumab monotherapy PFS 2.3 months vs. 1.3 placebo in refractory disease (RAINBOW)

Directional

5D2 lymphadenectomy standard, harvesting ≥15 nodes improves survival by 10-15%

Single source

6Adjuvant S-1 chemotherapy in Asia yields 5-year OS 71.7% vs. 61% surgery (ACTS-GC)

Verified

7Pembrolizumab ORR 60% (95% CI 49-70) in MSI-H/dMMR advanced gastric cancer (KEYNOTE-158)

Verified

8Total gastrectomy with Roux-en-Y in proximal tumors, 5-year survival 50-70% if stage I

Verified

9HIPEC (hyperthermic intraperitoneal chemo) reduces peritoneal recurrence by 20% in select cases

Directional

10Nivolumab + chemo improves OS to 13.8 months vs. 11.6 placebo arm (ATTRACTION-4 Japan)

Single source

11CAPOX (capecitabine+oxaliplatin) non-inferior to FOLFOX, used in 60% adjuvant regimens

Verified

12Endoscopic submucosal dissection (ESD) curative in 90-95% T1a intramucosal cancers <2cm

Verified

13Radiation dose 45 Gy with concurrent chemo for unresectable, local control 50-60%

Verified

14Regorafenib OS 5.8 vs. 4.5 months placebo in refractory (INTEGRATE)

Directional

15Gastrectomy morbidity 20-40%, mortality <5% in high-volume centers (>20/year)

Single source

16Irinotecan-based second-line therapy PFS 4 months median

Verified

17CLARITY trial: FLOT superior to ECX, pCR 16% vs. 7%

Verified

18Proton therapy reduces cardiac dose by 50% vs. IMRT in gastric RT

Verified

19Zolbetuximab + chemo ORR 37% in CLDN18.2+ (SPOTLIGHT trial)

Directional

20Palliative stent for GOO relieves symptoms in 80-90% within 24h

Single source

21Adjuvant CAPOX OS benefit 7% absolute at 3 years (CLASSIC trial Korea)

Verified

225-FU/leucovorin + cisplatin response 41% in metastatic (meta-analysis)

Verified

23Robotic gastrectomy reduces blood loss 200ml vs. laparoscopic, equivalent oncologic outcomes

Verified

24Avelumab maintenance OS 14.4 vs. 11.1 months post-FLX (JAVELIN)

Directional

25H. pylori eradication post-resection reduces metachronous cancer by 50% (MALT trial)

Single source

26FOLFIRI second-line OS 6.9 months (meta-analysis 10 trials)

Verified

Treatment Interpretation

Each of these statistics is a hard-won battle in a long war, proving that while stomach cancer remains formidable, we are systematically outflanking it with better knives, smarter drugs, and a clearer map of the terrain.