What is the most common cause of gastric cancer?

Appeared in: AIIMS Delhi NO - 2018

Explanation

H. pylori because it is the primary etiological agent for most cases of gastric adenocarcinoma.
This bacterium causes chronic inflammation (gastritis) of the stomach lining.
This long-term inflammation can lead to precancerous changes, including atrophic gastritis and intestinal metaplasia, which significantly increase the risk of cancer development.
Studies confirm that H. pylori infection increases the risk of gastric cancer by 3 to 6 times.

Option B: The stomach's normal acidic nature is a defense mechanism against pathogens. It is not a cause of cancer. In fact, conditions that reduce stomach acid (hypo- or achlorhydria), often resulting from chronic H. pylori infection, are considered pre-malignant.
Option C: Less peristalsis refers to decreased stomach motility (gastroparesis). This condition affects how the stomach empties but is not a recognized cause of gastric cancer.
Option D: This is a vague term. While lifestyle factors like diet (high salt, smoked foods), smoking, and alcohol consumption are risk factors, they are not considered the single most common cause. H. pylori infection is a much stronger and more direct causative agent.

Clinical Relevance

Nursing practice connection: Knowing Etiology of 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 the link between H. pylori and gastric cancer, especially in high-risk populations.
Screening for and eradicating H. pylori is a key primary prevention strategy for gastric cancer.
What if? If a patient has a first-degree relative with a history of gastric cancer, the nurse should recognize this as a significant risk factor and advocate for H. pylori testing and treatment, as this can substantially lower the patient's risk of developing the disease.

How to Approach the Question

First, identify the core question: it asks for the 'most common cause' of a specific disease (gastric cancer).
This is a factual recall question. Access your knowledge about the etiology of gastric cancer.
Evaluate each option based on its established role in the disease's pathophysiology.
Option A, H. pylori, is a well-known primary carcinogen for gastric cancer.
Option B, acidic nature, is a normal feature of the stomach; a lack of acid is the risk factor.
Option C, less peristalsis, relates to motility, not cancer development.

Concept Tested & Keywords

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

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

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

Practise the full AIIMS Delhi NO - 2018

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