Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- abdominal pain
- weight loss
- lymphadenopathy
Other diagnostic factors
- age 50-70 years
- male sex
- smoking
- family history
- nausea
- dysphagia
- lower gastrointestinal bleeding
Risk factors
- pernicious anaemia
- Helicobacter pylori
- N-nitroso compounds
- diet low in fruits and vegetables
- high-salt diet
- smoking
- family history
Diagnostic investigations
1st investigations to order
- upper gastrointestinal endoscopy with biopsy
- FBC
- comprehensive metabolic panel
Investigations to consider
- CT of chest/abdomen/pelvis
- endoscopic ultrasound
- laparoscopy
- PET/CT
Treatment algorithm
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.
Differentials
- Peptic ulcer disease
- Benign oesophageal stricture
- Achalasia
More DifferentialsGuidelines
- NCCN clinical practice guidelines in oncology: gastric cancer
- Immunotherapy and targeted therapy for advanced gastroesophageal cancer
More GuidelinesPatient information
Endoscopy (upper gastrointestinal)
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