What are the key symptoms and risk factors for stomach cancer that I should be aware of in my patients?

Key symptoms of stomach (gastric) cancer to be vigilant for in patients include persistent upper abdominal pain or discomfort, unexplained weight loss, early satiety, persistent nausea or vomiting, difficulty swallowing (dysphagia), and signs of gastrointestinal bleeding such as haematemesis or melaena. Other symptoms may include anorexia, fatigue, and anaemia-related symptoms like pallor. These symptoms often overlap with benign conditions but persistent or progressive symptoms warrant urgent investigation NICE NG12 Yang et al. 2023Mamun et al. 2024Sundar et al. 2025.

Key risk factors for stomach cancer include both modifiable and non-modifiable elements. Non-modifiable risk factors include older age (typically over 55 years), male sex, and a family history of gastric cancer NICE NG12. Modifiable risk factors include Helicobacter pylori infection, which is the strongest known risk factor, chronic gastritis, smoking, high salt intake, diets low in fruits and vegetables, and obesity. Other important risk factors are previous gastric surgery, pernicious anaemia, and certain genetic syndromes (e.g., hereditary diffuse gastric cancer) Mamun et al. 2024Yang et al. 2023Sundar et al. 2025.

In clinical practice, awareness of these symptoms combined with risk factors should prompt timely referral for endoscopic investigation to enable early diagnosis and improve prognosis NICE NG12.