Stomach Cancer Could Surge in Türkiye Without Preventive Action
In this article
🌍 Stomach Cancer: A Global Health Problem
Stomach cancer ranks fifth among the most common cancers worldwide and remains a major cause of cancer death. This once again highlights the vital importance of effective prevention strategies .
Stomach cancer has long been a quietly advancing threatto public health. A newly published major study covering 185 countries reveals how much this threat could grow in the future, with striking data . According to the study published on 7 July 2025 in Nature Medicine , 15.6 million lifetime stomach cancer cases are expected in the generation born in 2008–2017 , and approximately 76% (11.8 million cases) are preventable .
In this article, we examine Türkiye's place in this global picture and the preventive action that can be taken in detail.
🌐 Geographic Distribution: Who Faces Greater Risk?
- Approximately two-thirds of cases are concentrated in Asia . More than 10.6 million cases are expected there, representing 68% of all cases.
- Helicobacter pylori chronic infection-related stomach cancer casesaccount for 67% of the global burden.
- The Americasrank second with 2 million cases (%13), Africa ranks third with 1.7 million cases (%11).
- Because of demographic changes, 42% of stomach cancer cases are expected in countries where incidence is currently relatively low . In particular, in low-human-development-index regions such as sub-Saharan Africa, the burden is projected, compared with 2022, to increase 6-fold .
🇹🇷 Türkiye: Among the Highest-Risk Countries
According to the research, in Türkiye:
- Among those born between 2008–2017, 13.4 million peopleface a lifetime risk of stomach cancer.
- Nearly 400,000 new stomach cancer cases are expected.
- Of the cases, more than 70% are linked to H. pylori.
With this burden, Türkiye is among the world's top 25 countries for expected stomach cancer cases . This represents not only an individual issue but also a strategic national public health challenge .
Figure 1: Country-specific estimates of stomach cancer cases.
Aboveare country-specific expected stomach cancer case counts among people born between 2008 and 2017, assuming no change in current stomach cancer control measures, and cases attributable to H. pylori infection . a–c: Countries are grouped by their contribution to the global stomach cancer burden. Ranked by expected case counts, they are then divided into the following five categories:
- >1,000,000 cases (Group A; panel a)
- 100,000–1,000,000 cases (Group B; panel b)
- 35,000–100,000 cases (Group C; panel c)
📈 Why Is Stomach Cancer Incidence Increasing?
Although stomach cancer (gastric adenocarcinoma) has declined worldwide for many years, recent increases in some regions, particularly among young adults, have renewed attention. This rise is associated with multiple factors, including infection, diet, lifestyle, and the immune system.
🔬 1. Helicobacter pylori Infection
- H. pylori is responsible for 76–89% of stomach cancers.
- Transmitted through contaminated food, water, or interpersonal contact.
- Causes DNA damage through chronic inflammation, creating a setting for cancer.
- In Türkiye, more than 70% of adults carry this bacterium.
- According to WHO and IARC, eradicating it could substantially reduce stomach cancer incidence over the long term.
🧬 2. Autoimmune Gastritis and the Microbiota
- Although H. pylori is declining in countries such as the US, autoimmune gastritis-related stomach cancer risk is increasing.
- Widespread antibiotic use after 1950 may disrupt gastric microbiota, triggering autoimmunity.
⚠️ 3. Lifestyle: Obesity, Diet, and Inactivity
- Highly salted, processed, and smoked foods increase risk.
- Obesity and a Western-style diet (fast food, foods with additives) contribute through inflammation and insulin resistance.
- Alcohol and smoking increase risk through toxic effects on the gastric mucosa.
👶 4. Increasing Rates in Young Adults
- In the US and UK, stomach cancer rates in people under 50 are rising annually by 1.3–2.4% .
- The increase is particularly pronounced in young women .
- Genetic predisposition, autoimmune gastritis, smoking, alcohol, and antibiotic use may contribute.
🔢 A Summary in Scientific Numbers
| Risk Factor | Scientific Data / Estimate |
|---|---|
| H. pylori infection | 76–89% of stomach cancers are linked to this bacterium |
| Autoimmune gastritis | Increased noncardia stomach cancer risk |
| Antibiotic use | May create susceptibility by altering the microbiota |
| Obesity and unhealthy diet | Fast food and foods with additives increase inflammation |
| Rising incidence in young adults | Annual increase in the US: 2.43% in women; ≈ 0% in men |
Figure 2: Projected Future Increase in Stomach Cancer Risk (for Those Born in 2008–2017)
This world map shows, for generations born between 2008–2017, how expected stomach cancer cases compare with current cross-sectional estimates for 2022, indicating the projected fold increase .
🔷 Blue areasindicate that future risk may be lower than today's;
🟨 Light yellow areasrepresent countries expecting a 1- to 2-fold increase;
🟧 Orange areasrepresent countries expecting a 2- to 4-fold increase;
🟥 Red areas represent countries expecting a 6-fold or greater increase .
The map shows that risk may rise substantially, particularly in regions such as sub-Saharan Africa, and that the stomach cancer burden may shift toward areas traditionally considered low-incidence.
📌 Türkiyeis among the countries expecting a 2- to 4-fold increase. This suggests a substantial rise in stomach cancer incidence could occur without investment in prevention.
🦠 H. pylori: The Silent Culprit Behind Stomach Cancer
Chronic Helicobacter pylori infection is a major cause of stomach cancer—particularly noncardia stomach cancer . This infection is largely preventable through treatment with antibiotics and proton pump inhibitors .
The International Agency for Research on Cancer (IARC/WHO) has, since 2013, recommended that countries, considering local disease burden, other health priorities, and cost-effectiveness analyses, initiate H. pylori screening and treatment programs .
Helicobacter pyloriis a spiral-shaped bacterium that colonizes the stomach lining and may remain symptomless for a long time. Over time, however, it can lead to:
- Chronic gastritis,
- Stomach ulcers,
- Atrophic gastritis,
- and eventually stomach cancer .
Among adults in Türkiye, more than 70% carry this bacterium. In Northern Europe , the rate is below 30%. Common but silent, the infection can, because of insufficient awareness, remain untreated for years.
📈 2025 and Beyond: Is the Increase Inevitable?
According to the study's projections, if current control measures remain unchanged:
- In today's children, stomach cancer risk compared with 2022 will be 2 to 6 times higher .
- Rapid population growth and agingwill further increase this burden.
- China and Indiawill account for 42% of cases. However, countries such as Türkiye are also in the high-risk group.
💸 Why Is Investment Insufficient?
Despite being preventable , stomach cancer, compared with other infection-related cancers such as cervical or liver cancer, receives insufficient investment . Key reasons include:
- Inadequate cancer registries,
- Silent infection leading to limited awareness,
- Different political and budget priorities.
Yet strong scientific evidence shows that H. pylori eradication substantially reduces stomach cancer incidence over the long term .
✅ Prevention Strategies: H. pylori Screening and Treatment
Population-level H. pylori screening and treatment strategiescould reduce future stomach cancer cases by up to 75% . These programs have been found cost-effective particularly in areas currently experiencing low or moderate incidence.
Countries such as South Korea and Japan use endoscopic screening programs alongside H. pylori screening and treatment models . Europe also includes such strategies in Europe's Beating Cancer Plan .
🛡️ What Should Türkiye Do? A Roadmap With 3 Recommendations
1️⃣ H. pylori Screening and Treatment Program
Successfully used in countries such as South Korea, Japan, and Bhutan, the “screen-and-treat” model could also be implemented in Türkiye.
📉 This program could reduce stomach cancer cases by up to 75%.
2️⃣ Early Endoscopy for At-Risk Groups
- People over 40
- Those with a family history of stomach cancer
- Those with chronic stomach symptoms
These groups should be prioritized for H. pylori testing and endoscopy at family health centers .
3️⃣ Population-Level Awareness Campaigns
Lack of knowledge about H. pylori is widespread.
Using television, social media, schools, and mosques, public education campaigns should be organized.
💉 Is a Vaccine on the Horizon?
Having completed a Phase 3 clinical trial in China, an H. pylori vaccineis being prepared for inclusion in global prevention strategies. This vaccine:
- Could be accessible and effective particularly in low- and middle-income countries.
- May reduce not only stomach cancer, but also common complaints such as dyspepsia and stomach ulcers .
✅ Conclusion: Inaction Will Have Consequences
Nature Medicine data clearly show that Türkiye is at a critical threshold in tackling stomach cancer .
Screening, treatment, and awareness efforts could prevent hundreds of thousands of cases.
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