Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2020; 26(13): 1382-1393
Published online Apr 7, 2020. doi: 10.3748/wjg.v26.i13.1382
Hereditary gastric cancer: Three rules to reduce missed diagnoses
Paula Assumpção, Taíssa Araújo, André Khayat, Geraldo Ishak, Sidney Santos, Williams Barra, João Felipe Acioli, Benedito Rossi, Paulo Assumpção
Paula Assumpção, Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Pará, Belém 66075-110, Brazil
Taíssa Araújo, André Khayat, Sidney Santos, Williams Barra, Paulo Assumpção, Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Belém 66073-000, Brazil
Geraldo Ishak, João Felipe Acioli, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém 66073-000, Brazil
Benedito Rossi, Centro de Oncologia e Aconselhamento Genético, Hospital Sírio Libanês, São Paulo 01308-050, Brazil
Author contributions: All authors equally contributed to this paper in terms of the conception and design of the study, literature review and analysis, drafting and critical revision and editing, and approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Paulo Assumpção, MD, PhD, Academic Research, Adjunct Professor, Surgical Oncologist, Núcleo de Pesquisas em Oncologia, Universidade Federal do Pará, Rua dos Mundurucus 4487, Belém 66073-000, Brazil. assumpcaopp@gmail.com
Received: December 10, 2019
Peer-review started: December 10, 2019
First decision: February 14, 2020
Revised: February 17, 2020
Accepted: March 9, 2020
Article in press: March 9, 2020
Published online: April 7, 2020
Processing time: 118 Days and 0.6 Hours
Abstract

Gastric cancer remains one of the most lethal cancers. The incidence and mortality rates are quite similar. The main reason for the high mortality is diagnosis at advanced stages of disease, when treatment options are poor. One of the supposed strategies to overcome late-stage diagnosis is identifying people at high risk with the aim of establishing rigorous clinical control, including routine endoscopy and biopsies. Hereditary gastric cancer (HGC) syndromes, though representing a sizeable group to monitor for prevention or, at least, for early diagnosis, are apparently extremely rare. The low rate of HGC diagnosis might be related to the low rates of suspicion, insufficient familiarity about clinical diagnosis criteria, and the supposed conditional necessity of a molecular diagnosis. In this review, we will discuss simple measures to increase HGC diagnosis by applying three rules that might provide an opportunity for precision care to benefit the families affected by this disease.

Keywords: Hereditary gastric cancer; Rules; Diagnosis

Core tip: Although familial gastric cancer cases represent a potential source for the discovery of early-stage gastric cancer (and others) among patients’ relatives, this possibility has been little explored due to the low rate of suspicion of hereditary gastric cancer syndromes, which could be improved by applying simple rules for hereditary gastric cancer screening that are accessible for unskilled healthcare professionals.