[Scientific foundation of gastric cancer control (author's transl)].

Although many facts on epidemiology of gastric cancer and on the preceding atrophic gastritis are known, sufficient scientific foundations for planning primary prevention are lacking. It is suggested that with rising standards of living and hygiene and with dissemination of optimal nutrition according to physiologic aspects, incidence of gastric cancer will further decrease. 2. It is possible to identify some high risk groups: elderly persons with familial aggregation of stomach cancer, blood group A, pernicious anemia, atrophic gastritis and intestinal metaplasia, anacidity, and patients operated upon for benign epithelial neoplasms or gastric ulcer. Prophylactic supervision of this segment of the population seems mandatory but by this means, only a small percentage of all gastric cancer can be detected early. 3. Our knowledge is sufficient for the planning of intervention studies, e.g. long tome prophylactic application of ascorbic acid or vitamin A or intensive drug treatment of atrophic gastritis. Therefore we have started such a trial using carbenoxolon. 4. Screening methods for detection of early gastric cancer in asymptomatic persons have been evaluated in Japan. Their application in Europe cannot be generally recommended. The cost-benefit ratio is prohibiting. 5. Today, the main route to detect stomach cancer when curable is the thorough examination of persons with dyspeptic complaints. Radiological examination holds the first place and is supplemented by fibergastroscopy which enables aimed biopsy and cytologic examination of gastric juice. All other methods have only limited value in selected situations. 6. Without resignation we must realize that a solution of the problem cannot be expected in the near future. Further efforts are necessary in order to gain solid scientific foundations and to introduce research results into medical practice.