Eradication of Helicobacter pylori, adoption of a healthy lifestyle and diet, and targeted endoscopic surveillance in high-risk individuals constitute the most effective strategies to prevent gastric cancer.
Primary Prevention involves eradication of helicobacter pylori in all high risk induviduals . The International Agency for Research on Cancer (IARC) recommends population-based screen-and-treat strategies where gastric cancer burden is high, with careful antibiotic stewardship and monitoring of outcomes.
Dietary patterns: High intake of fresh fruits and vegetables is associated with a lower risk of gastric cancer, whereas high-salt diets and frequent consumption of salt-preserved foods increase risk.
Smoking cessation: Current smokers have a 1.5-fold higher risk; quitting reduces risk over time.
Alcohol moderation: Heavy alcohol intake modestly elevates risk; limiting to ≤1 drink/day is advisable.
Body weight and activity: Maintaining a BMI of 18.5–24.9 kg/m² and engaging in moderate exercise confers additional protection.
Low-dose aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) have been studied for chemoprevention, with mixed results and potential bleeding risks. Routine use is not currently recommended solely for gastric cancer prevention.
Endoscopic Surveillance. High-risk groups—including first-degree relatives of gastric cancer patients, individuals with gastric intestinal metaplasia or extensive atrophic gastritis, and immigrants from high-incidence regions—should undergo high-definition upper endoscopy with systematic biopsy protocols every 2–3 years. Endoscopic techniques such as narrow-band imaging and magnification enhance detection of dysplasia or early carcinoma