The cause of gastric cancer is?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Explanation

Helicobacter pylori (H. pylori) infection is the single strongest known risk factor for gastric adenocarcinoma.
The bacterium induces chronic inflammation in the gastric mucosa, which is the primary driver of carcinogenesis.
This long-term inflammation leads to a sequence of precancerous changes known as the Correa cascade: chronic gastritis → atrophic gastritis → intestinal metaplasia → dysplasia → carcinoma.
Epidemiological studies show that H. pylori infection increases the risk of developing gastric cancer by 3 to 6 times.
Eradication of H. pylori infection has been proven to decrease the subsequent risk of developing gastric cancer.

Option B: The stomach's normal acidic environment is not a cause of cancer. In fact, a key pre-malignant condition, atrophic gastritis, is characterized by hypo- or achlorhydria (low or absent stomach acid).
Option C: Less peristalsis, or gastroparesis, is a disorder of gastric motility (emptying). It is not recognized as a direct etiological factor for gastric cancer.
Option D: This term is too vague and not a recognized medical risk factor. While specific lifestyle choices (part of daily living) like diet and smoking are risk factors, the term itself is incorrect.

Clinical Relevance

Nursing practice connection: Knowing Etiology and risk factors for gastric cancer helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a crucial role in educating patients about H. pylori, including the importance of testing (e.g., urea breath test, stool antigen) and adhering to the full course of eradication therapy.
Patient counseling on modifiable risk factors is a key nursing intervention. This includes advising a diet low in salted, smoked, and pickled foods, and rich in fruits and vegetables, as well as smoking cessation.
What if? If a patient has a first-degree relative with gastric cancer, their own risk is significantly increased. In this scenario, screening for and treating an asymptomatic H. pylori infection is a recommended preventive strategy.

How to Approach the Question

This is a factual recall question that asks for a direct cause of a specific disease.
First, identify the core concept of the question: the etiology of 'gastric cancer'.
Systematically evaluate each option based on your knowledge of gastrointestinal pathophysiology.
Recall that H. pylori infection is a well-established Class I carcinogen and the most significant risk factor for gastric cancer.
Eliminate options that are physiologically incorrect (Acidic nature), related to a different pathology (Less peristalsis), or too vague to be a specific cause (Activity daily living).

Concept Tested & Keywords

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E6 Medicine Harrison 22e Part 1 p. 686-688

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 3 (515-969) p. 37-39

E6 PATHOLOGY QUICK REVIEWBased on Harsh Mohan Textbook of PATHOLOGY p. 144-146

Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.