Avoid Stomach CancerUp until the 1930's the number one cancer killer in the United States was stomach cancer. Its incidence has dropped dramatically in the last 50 years but it still kills about 15,000 Americans annually. In Japan, stomach cancer still kills more people than breast, colon and prostate cancers combined although it has been declining rapidly for the last 30 years. The dramatic drop in stomach cancer incidence and deaths in the U.S. and Japan are likely due in part to refrigeration and other advances in food preservation that lead to a reduced reliance on older methods of food preservation such as salting, smoking, pickling and curing meats with nitrites.Nitrites combine with amino acids to form a class of carcinogenic chemicals called nitrosamines. Smoking and pickling of foods leads to the formation of known and suspected carcinogens. Salt may act as a promoter of stomach cancer when these chemicals are present. Salt in large amounts can damage the stomach lining and contribute to the development of atrophic gastritis, a condition associated with increased risk of stomach cancer.Another major cause of stomach cancer is the bacteria that causes most ulcers and a lot of gastritis (Helicobacter pylori). This bacterial infection can be cured with antibiotics this should help prevent stomach cancer. Chronic H. pylori infection can lead to atrophic gastritis, a condition associated with a greatly increased risk of stomach cancer [Hansson LE et al N Engl J Med 1996;335:242-9]. This bacteria currently infects about 1 in 3 Americans.An increased consumption of fruits and vegetables also appears to reduce the risk of stomach cancer. The year round availability of fresh and frozen fruits and vegetables is also likely to be contributing to the decline of stomach cancer in America, Japan and other more developed countries.The bottom line: A diet with more fresh fruits and vegetables should help prevent stomach cancer. A reduction in highly salted, pickled or smoked foods and cured meats should also help prevent stomach cancer. People with atrophic gastritis, a history of ulcers or strong family history of stomach cancer and/or Type A blood (a genetic marker for increased risk) should be screened for H. pylori infections and treated with antibiotics to eradicate the infection.By James J. Kenney, PhD, RD, FACN.