People aged 50 and older are advised to undergo stomach cancer screening, with physicians saying that risk factors include a family history of the disease, long-term smoking, frequent consumption of preserved or smoked foods such as sausages and cured meats, and infection with Helicobacter pylori — a common cause of stomach inflammation.
Kaohsiung Medical University Chung-Ho Memorial Hospital gastroenterologist Wu Teng-chiang (吳登強) made the remarks after Deputy Minister of Health and Welfare Chuang Jen-hsiang (莊人祥) confirmed that he had been diagnosed with stomach cancer early last year.
Chuang wrote on Facebook on Thursday that the cancer was discovered early last year while he was serving as director-general of the Centers for Disease Control. He thanked the public for their concern, and expressed gratitude to his medical team at Taipei Veterans General Hospital and to his family for their support, saying he had “recovered well” and joked that “my ancestors must have been watching over me.”
Photo: Tsai Yun-jung, Taipei Times
According to the Ministry of Health and Welfare’s 2022 Cancer Registry Report, stomach cancer ranked eighth among all cancers in Taiwan, with 4,377 new cases recorded last year.
The age-standardized incidence rate was 9.8 per 100,000 people, up slightly from 2021, and the median age at diagnosis was 69. The mortality rate stood at 4.9 per 100,000.
The report also highlighted a gender gap: the incidence rate among men was 12.6 per 100,000, ranking seventh, compared with 7.4 per 100,000 for women, ranking 10th.
Data from the WHO showed that among 800,000 people with stomach cancer worldwide, 335,000 were infected with H pylori, suggesting the bacterium is associated with an eightfold higher risk of developing the disease.
Early-stage stomach cancer often shows no obvious symptoms, so detection relies heavily on screening and regular health checkups, Wu said.
About 80 percent of stomach cancer cases in Taiwan are linked to H pylori infection, Wu said, adding that from next year, the government plans to offer free lifetime stomach cancer screening for people aged 45 to 74 to help lower incidence rates.
Estrogen provides some protection for women before menopause, making the incidence rate among men about twice as high before age 50, he said.
After menopause, the gender gap narrows significantly, he added.
Other bacteria and imbalances in gut microbiota have also been found to contribute to stomach cancer, along with heavy smoking, he said.
Stomach cancer is among the most common malignancies in Asia, particularly for adults aged 50 and older.
Because early symptoms such as indigestion, heartburn, persistent upper abdominal pain and unexplained weight loss resemble those of stomach ulcers, the disease is often detected late, Wu said.
Early detection significantly improves survival outcomes, with five-year survival rates of up to 90 percent, compared with about 3 percent for late-stage cases, he said.
Excessive intake of salt and nitrates, common in preserved or processed foods, can damage the stomach lining and increase the risk of cancer, Wu said.
High salt concentrations might cause atrophic gastritis and cell mutations in early stages, while promoting cancer cell growth later on, he said.
Nitrates can also form nitrosamines, compounds linked to stomach cancer, especially in diets high in preserved or pickled foods, he added.
Nutritional deficiencies — particularly lower consumption of protein, fats, and vitamins A and C — as well as a history of gastric surgery or chronic gastritis, also increase risk, Wu said.
Although the incidence of stomach cancer in Taiwan has declined as people consume fewer smoked and preserved foods, other risk factors, including poor nutrition, alcohol and tobacco use, and a family history of cancer, remain significant, he said.
People without significant risk factors or abnormal findings can undergo endoscopic examinations every five to six years, while those with risk factors or precancerous conditions such as atrophic gastritis or intestinal metaplasia should be screened every two to three years, he added.
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