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ESMO PRECEPTORSHIP ON Gastric Cancer: Epidemiology (including GE - - PowerPoint PPT Presentation
ESMO PRECEPTORSHIP ON Gastric Cancer: Epidemiology (including GE - - PowerPoint PPT Presentation
ESMO PRECEPTORSHIP ON Gastric Cancer: Epidemiology (including GE junction) and clinical presentation Dr Yong Wei Peng National University Cancer Institute, Singapore 20 Nov 2019 DISCLOSURES Advisory board: Abbie, Amgen, Aslan pharmaceutic,
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INCIDENCES OF GC WORLDWIDE
GLOBOCAN 2018 (IARC)
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GLOBOCAN 2018 (IARC)
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TRENDS IN INCIDENCES OF GC
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CAUSES FOR REDUCTION IN INCIDENCE AND MORTALITY
Improved food preservation practices
- use of refrigeration
- less pickling of vegetables
- less smoking and processing of meat
- greater availability of fresh fruits and vegetables
Reduction in H Pylori infection Early cancer detection Surgical and oncologic advances
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CARDIA CANCER
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RISK FACTORS FOR GC
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RISK FACTORS FOR GC
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- H. Pylori infection
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PATHOGENESIS OF GASTRIC CANCER
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CAG-A IS A MAJOR VIRULENCE FACTOR OF H.PYLORI
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H.PYLORI IN WESTERN AND EAST ASIAN ISOLATES
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EBV INFECTION
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FAMILIAR GASTRIC CANCER SYNDROME
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FAMILIAR GASTRIC CANCER SYNDROME
10% of gastric cancers show familial clustering Hereditary Diffuse Gastric Cancer (E-cadherin mutation): Elevated risk of lobular breast cancer and possibly colorectal cancer. Histologically, gastric tumors are highly invasive, poorly differentiated, and display occasional signet ring cells. The lifetime penetrance of HDGC is about 65%, Age of onset shows from 14 years upward with a median age in the late thirties. ESMO Clinical Practice Guidelines: If a familial cancer syndrome such as hereditary diffuse GC (HDGC) is suspected, ideally, referral to a geneticist for assessment is recommended based on international clinical guidelines.
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LYNCH’S SYNDROME
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AETIOLOGY AND MOLECULAR CLASSIFICATION OF AGC AND EC
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CLINICAL PRESENTATION
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DIAGNOSIS & STAGING
ESMO guideline recommendation: Diagnosis should be made from a gastroscopic or surgical biopsy reviewed by an experienced pathologist, and histology should be reported according to the World Health Organisation (WHO) criteria.
https://oncologypro.esmo.org/Guidelines/Clinical-Practice-Guidelines/Gastrointestinal-Cancers/Gastric-Cancer
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CONCLUSIONS
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