(1) Changing unhealthy dietary habits.
We should avoid or reduce the consumption of foods that are deep-fried or cooked at high temperatures, as this can lead to the formation of carcinogenic substances in the oil, especially when the oil is reused multiple times. Additionally, meat and fish that are fried or grilled may also produce carcinogenic heterocyclic compounds. Therefore, we should try to minimize the intake of fried foods.
Similarly, we should also try to minimize the consumption of smoked and grilled foods, as these processes can generate carcinogenic substances such as benzopyrene. For example, residents in Iceland often consume smoked lamb, while coastal residents in the former Soviet Union prefer smoked fish, leading to much higher rates of digestive tract cancer in these regions compared to others. Hence, we should avoid consuming charred parts of food, as they tend to have the highest levels of benzopyrene.
Furthermore, we should try to reduce the consumption of salt-preserved foods, as a high-salt diet can contribute to hypertension and has carcinogenic effects. Cured meats may contain small amounts of nitrosamines, which can be a potential trigger for various types of cancer. Therefore, we should try to avoid excessive consumption of salt-preserved foods.
Lastly, we should try to avoid consuming food contaminated with molds, such as sauerkraut, fish sauce, shrimp paste, etc., which are common in high-risk areas. We encourage the consumption of fresh foods and improvements in cooking methods to minimize the intake of carcinogenic substances in our diet.
(2) Improving nutritional status.
We should increase the intake of soy products, fresh vegetables, and fruits in moderation, as these foods are rich in vitamin C and E, as well as beta-carotene. These nutrients help to inhibit the synthesis of carcinogenic substances such as nitrosamines. Additionally, maintaining a balanced diet contributes to enhancing the immune function of the body. Therefore, we should consume these nutrient-rich foods to promote overall health and resilience.
(3) Treatment of Helicobacter pylori infection (Hp infection).
Approximately half of the global population is infected with Hp, but not all infected individuals require Hp eradication treatment. According to the National Institutes of Health in the United States in 1994:
- Hp-positive patients with gastric ulcers and duodenal ulcers, whether it is the first occurrence or a recurrence, should receive Hp eradication treatment.
- For patients with non-ulcer dyspepsia, whether Hp eradication treatment is necessary remains inconclusive.
- Currently, Hp eradication treatment is not recommended for the purpose of preventing gastric cancer.
In April 1999, the Chinese Hp Research Collaboration Group proposed the indications for Hp eradication treatment in China:
- Hp eradication treatment is necessary for patients with peptic ulcers, low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and postoperative early gastric cancer.
- Hp eradication treatment is supported for individuals with significant symptoms of gastritis, planned long-term use or current use of nonsteroidal anti-inflammatory drugs, and a family history of gastric cancer.
- Hp eradication treatment is not supported for the purpose of preventing gastric cancer or for individuals without risk factors who wish to undergo treatment.
- Whether Hp eradication treatment is necessary for functional dyspepsia and diseases outside the stomach and duodenum is currently unclear.
(4) Quit smoking and minimize alcohol consumption.
(5) Actively treat precancerous diseases and precancerous lesions.
(6) Gastric cancer screening.
Japan and the United States are leading in the field of gastric cancer screening research globally. In areas with a high incidence of gastric cancer, large-scale screening programs are implemented to identify patients with early-stage gastric cancer. Early gastric cancer resection or curative surgery is performed using endoscopy, with the goal of achieving early diagnosis and treatment to improve survival rates and reduce mortality.