[Primary prevention and detection of gastric cancer]

Stomach cancer, the worl&dacute;s most common malignant neoplasia in 1980, has shown a decrease in death and incidence rates in several countries. Still not totally elucidated, the decline in incidence and death rates has been attributed to environmental factors. It is unlikely that the decline has stemmed primarily from changes in either the treatment system or diagnostic techniques. In Brazil, stomach cancer has been a major challenge, since the country faces high incidence and death rates. In addition, the Brazilian health system lacks the means to assume, fund, and develop a stomach cancer diagnostic program. According to current knowledge, stomach cancer develops from damage to the gastric mucosa by a diet rich in salt, nitrates/nitrites, and possibly carbohydrates. Initiation and development can be offset by a sufficient intake of fruit and fresh vegetables. Household refrigeration, widespread since the early 20th century, has helped people consume fresher, well-preserved food, no doubt generating a major downward impact on stomach cancer rates. In present-day Brazil, a national policy aimed at stomach cancer control must be based on rebuilding the health system and expanding patients' access to it, disseminating information on diet changes, and improving socioeconomic conditions.