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Last reviewed: 6 Feb 2025
Last updated: 13 Sep 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • abdominal pain
  • weight loss
  • lymphadenopathy
Full details

Other diagnostic factors

  • age 50-70 years
  • male sex
  • smoking
  • family history
  • nausea
  • dysphagia
  • lower gastrointestinal bleeding
Full details

Risk factors

  • pernicious anaemia
  • Helicobacter pylori
  • N-nitroso compounds
  • diet low in fruits and vegetables
  • high-salt diet
  • smoking
  • family history
Full details

Diagnostic investigations

1st investigations to order

  • upper gastrointestinal endoscopy with biopsy
  • FBC
  • comprehensive metabolic panel
Full details

Investigations to consider

  • CT of chest/abdomen/pelvis
  • endoscopic ultrasound
  • laparoscopy
  • PET/CT
Full details

Treatment algorithm

ACUTE

localised: suitable for surgery

localised: not suitable for surgery

advanced and metastatic disease

Contributors

Authors

Ahmed Abdelhakeem, MD

Fellow Physician

Division of Hematology and Oncology

Mayo Clinic - Mayo Clinic Comprehensive Cancer Center

Jacksonville

FL

Disclosures

AA declares that he has no competing interests.

Mariela Blum Murphy, MD

Associate Professor

Department of GI Medical Oncology

University of Texas

MD Anderson Cancer Center

Houston

TX

Disclosures

MBM declares that she has no competing interests.

Acknowledgements

Dr Ahmed Abdelhakeem and Dr Mariela Blum Murphy would like to gratefully acknowledge Dr Valerie Reed and Dr Prajnan Das, previous contributors to this topic.

Disclosures

VR and PD declare that they have no competing interests.

Peer reviewers

Theodore Hong, MD

Director

Gastrointestinal Radiation Oncology

Massachusetts General Hospital Cancer Center

Boston

MA

Disclosures

TH declares that he has no competing interests.

Andreas Leodolter, MD

Head of Department

Department of Gastroenterology

Sana Klinikum

Remscheid

Germany

Disclosures

AL declares that he has no competing interests.

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