Hereditary Gastric Cancer

What is hereditary gastric cancer?

Gastric cancer is cancer of the stomach. Hereditary gastric cancer refers to stomach cancer caused by an inherited gene change (mutation) that can be passed from parents to their children.

Who is at risk for gastric cancer?

Anyone can develop gastric cancer, but some people have a higher risk than others. Risk may be affected by:

Medical conditions

• infection with a bacteria known as Helicobacter pylori (H. pylori)
• long-term inflammation of the stomach lining (gastritis)
• gastroesophageal reflux disease (GERD), when stomach acid repeatedly flows back into the esophagus
• obesity

Genetics and family history

• a family history of stomach cancer
• an inherited mutation known to increase the risk of stomach cancer

Other factors

• smoking
• weight
• diets high in salty, smoked or processed foods
• diets low in fruits and vegetables
• heavy alcohol use

How common is gastric cancer?

In the general population, the average risk for stomach cancer is about 1%. This means that about 1 out of every 100 people will develop stomach cancer in their lifetime. The risk for men is higher (1 in 96) than for women (1 in 152).

For people with certain risk factors, the lifetime risk may be much higher.

Is gastric cancer genetic?

All gastric cancers are caused by damage to genes in the cells of the stomach. Most of this damage happens during the course of a person's lifetime. 

Some gastric cancers are hereditary. These are caused by inherited mutations that are present at birth and can be passed on from parents to their children. 

How can I learn if the gastric cancer in my family is hereditary?

Genetic counseling and testing can help people learn if the gastric cancer in their family is hereditary. 

For people diagnosed with gastric cancer, the location and subtype of the cancer and biomarker testing can provide additional clues about whether their cancer may be hereditary. Some of the signs of hereditary gastric cancer include:

• diagnosis with a rare subtype called signet ring cell carcinoma (may also be referred to as diffuse gastric cancer)
• young-onset cancers (diagnosed before age 50)
• multiple cancers diagnosed in the same person
• multiple people in a family with gastric, colorectal, endometrial or other types of cancer

You can read more about gastric cancer genetic testing here. 

How common is hereditary gastric cancer?

About 10% of all gastric cancers are caused by inherited mutations that can be passed on from parents to their childrens. 

What can people do to manage their gastric cancer risk?

There are three main medical approaches to managing an increased colorectal cancer risk: 

• increased screening
• medications to lower risk
• risk-reducing surgery

Each of these options comes with benefits, costs and risks. Expert guidelines for colorectal cancer risk management are based on your level of risk.

How is stomach cancer detected?

Gastric cancer is often detected at an advanced stage, but it can be found early with regular screening. Upper endoscopy with biopsy is considered the best screening method for people at high risk. This procedure is performed under anesthesia. 

Guidelines on the age to begin and the frequency of gastric cancer screening differ based on a person's gene mutation, family history of cancer, estimated lifetime risk and other factors. Visit this page for more information. 

How are hereditary gastric cancers different?

Hereditary gastric cancers tend to occur at a younger age and are linked to inherited mutations in the genes listed above. They may have unique features. For example, the biomarkers MSI-H or dMMR are often seen in cancers of people with Lynch syndrome. Cancers associated with mutations in CDH1 and CTNNA1—called signet ring cell carcinomas—look different under the microscope and behave differently than other forms of gastric cancers.

You can learn more about treatment options for gastric cancer here.