Cancer · UKMLA & AKT
Gastric cancer
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- H. pylori - WHO Group 1 carcinogen; most important modifiable cause; follows Correa cascade (chronic gastritis → atrophic gastritis → intestinal metaplasia → dysplasia → adenocarcinoma)
- Pernicious anaemia - 2-3 fold increased risk; B12 replacement corrects anaemia but does NOT reverse atrophic gastritis; persistent achlorhydria and parietal cell loss sustains malignant transformation risk
Pernicious anaemia = low B12 + macrocytic anaemia + angular cheilitis. Even with adequate B12 injections, the underlying atrophic gastritis persists - the gastric cancer risk remains.
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