Gastric cancer ranks second among the most common causes of cancer death in China. More than 90% of gastric cancer are considered as the ultimate consequence of a longstanding mucosal inflammation. Helicobacter pylori (H. pylori)infection is the leading etiological cause of gastritis,which may result in atrophy,intestinal metaplasia and dysplasia of the gastric mucosa,and finally the occurrence of gastric cancer (Correa's Cascade of intestinal type of gastric cancer). This well-understood natural history provides the rationale for primary and secondary cancer prevention strategies. A large body of evidence demonstrates that combined strategies of primary (H. pylori eradication) and secondary (endoscopic screening and surveillance)prevention may prevent or limit the progress of gastric oncogenesis. In this article, the importance of primary prevention of gastric cancer is emphasized.%胃癌在中国癌症死亡最常见原因中位居第二.90%以上的胃癌被认为是胃黏膜长期炎症的终末结果.幽门螺杆菌感染是胃炎最主要的病因,可导致胃黏膜萎缩、肠化生和异型增生,最终发生胃癌(Correa提出的肠型胃癌发生过程).这一已被完全了解的胃癌发生自然史为胃癌的一级预防和二级预防策略提供了合理依据.大量证据表明,一级预防(根除幽门螺杆菌)与二级预防(内镜筛查和随访)联合的策略可预防或限制胃癌发生的进程.本文旨在强调胃癌一级预防的重要性.
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