Hereditary gastric cancer: Three rules to reduce missed diagnoses

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.