Risk factors predisposing to cardia gastric adenocarcinoma: Insights and new perspectives

Abstract

Recent decades have seen an alarming increase in the incidence of cardia gastric adenocarcinoma (CGA) while noncardia gastric adenocarcinoma (NCGA) has decreased. In 2012, 260 000 CGA cases (age‐standardised rate (ASR); 3.3/100 000) and 691 000 NCGA cases (ASR; 8.8/100 000) were reported worldwide. Compared with women, men had greater rates for both the subsites, especially for CGA. Recently, four molecular subtypes of GC have been proposed by the Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG); however, these classifications do not take into account predisposing germline variants and their possible interaction with somatic alterations in carcinogenesis. The etiology of adenocarcinoma of the cardia and the gastroesophageal junction (GEJ) is not known. It is thought that CGA is distinct from adenocarcinomas located in the esophagus or distal stomach, both epidemiologically and biologically. Moreover, CGA is often identified in the advanced stage having a poor prognosis. Therefore, understanding the risk and the role of predisposing factors in etiology of CGA can inform clinical practice and counseling for risk reduction. In this paper, we showed that GC family history, lifestyle, demographics, gastroesophageal reflux disease, Helicobacter pylori infection, and multiple genetic and epigenetic risk factors as well as several predisposing conditions may underlie susceptibility to CGA. However, several genome‐wide association studies (GWASs) should be conducted to identify novel high‐penetrance genes and pathways as well as causal germline variants predisposing to CGA. They must include different ethnic groups, especially from high‐incidence countries for CGA, because some risk loci are ancestry‐specific. In parallel, statistical methods can be developed to identify cancer predisposition genes (CPGs) from tumor sequencing data. It is also necessary to find novel long noncoding RNAs related to the risk of CGA. Taken altogether, new cancer risk prediction models, including all genetic and nongenetic factors influencing risk, should be developed to facilitate risk assessment, disease prevention, and early diagnosis and intervention of CGA in the future.

The Association between ABCB1 C1236T/C3435T SNPs and H. pylori Infection among Jordanians

“…pylori infection is one of the most common bacterial infections, affecting approximately half of the world population [1,2]. It can cause chronic gastritis, which in turn may be complicated with peptic ulcer disease, lymphoma, and gastric adenocarcinoma [3,4]. The major factor that affects the rates of cure from H. pylori infection is the sufficient inhibition of acid secretion using the anti-secretory agents such as proton pump inhibitors (PPIs) [5,6].…”

Clinical significance and prognostic value of C-reactive protein/albumin ratio in gastric cancer

“…Development and progression of cancer is a complicated process, and many factors have been showed to contribute to the gastric carcinogenesis. Among them, systemic inflammatory response and nutritional status are two important contributors [21] . Evidences showed that CAR was an important inflammation-based prognostic indicator that associated with various cancer survival outcomes [22,23] .…”

Comorbidities associated with regional variations in COVID-19 mortality revealed by population-level analysis

“…We thus analyzed the transcriptome of stomach adenocarcinoma (STAD), which is the most common type of stomach cancer, 25 against the transcriptome of colon carcinoma (COAD).…”