[Hinews] [Physician's Column] By Dae-wook Im, Director of Internal Medicine, Taereung Bang Hospital

Stomach cancer, or gastric cancer, is among the deadliest cancers worldwide. In South Korea, it is the fourth most common, after thyroid, colorectal, and lung cancers. Unlike cancers driven by a single factor, gastric cancer develops through a complex interaction of genetic predisposition and environmental influences. Notably, the Korean diet, often rich in spicy and salty foods, is linked to an elevated risk of developing this disease.

In its early stages, gastric cancer often produces no clear symptoms, making it difficult to distinguish from common digestive complaints such as dyspepsia or indigestion. Some patients may notice unexplained weight loss or reduced appetite. More serious signs—including persistent nausea, vomiting, difficulty swallowing, black stools (melena), or a palpable abdominal mass—usually indicate advanced disease.



Early detection is crucial. Regular health screenings can identify gastric cancer before symptoms appear. When detected at stage I, the five-year survival rate is close to 90%. In South Korea, gastroscopy is recommended every one to two years for adults aged 40 and above. Those with frequent digestive issues, chronic gastritis, or a family history of gastric cancer should be particularly vigilant.

Once gastric cancer advances, treatment becomes far more complex, reinforcing the need for regular gastroscopy. Experts recommend screening every two years for those over 40, and yearly for individuals with risk factors such as family history of gastric cancer, atrophic gastritis, intestinal metaplasia, or precancerous dysplasia.

Prevention depends largely on lifestyle, particularly diet. Limiting salty, smoked, or heavily processed foods containing nitrates is essential. A diet rich in fresh fruits and vegetables—especially those high in vitamin C, beta-carotene, and vitamin A—has been shown to lower gastric cancer risk.