The diffuse-type gastric cancer epidemiology enigma
Paulo Pimentel de Assumpção, Williams Fernandes Barra, Geraldo Ishak, Luiz Gonzaga Vaz Coelho, Felipe José Fernández Coimbra, H. Freitas, Emmanuel Dias‐Neto, M. Constanza Camargo, Moysés Szklo
Abstract
BACKGROUND: Intestinal and diffuse gastric adenocarcinomas differ in clinical, epidemiological and molecular features. However, most of the concepts related to the intestinal-type are translated to gastric adenocarcinoma in general; thus, the peculiarities of the diffuse-type are underappreciated. RESULTS: Besides its growing importance, there are many gaps about the diffuse-type carcinogenesis and, as a result, its epidemiologic and pathogenetic features remain poorly understood. CONCLUSIONS: Alternative hypotheses to explain these features are discussed, including the role of the gastric microbiota, medical therapies, and modifications in the stomach's microenvironment.