A summary of the National Cancer Institute Think Tank on Advancing Gastric Cancer Prevention

Gastric cancer remains a major health challenge globally. In the United States, gastric cancer outcomes remain poor, with well-documented disparities in incidence and mortality. In 2024, the US National Cancer Institute convened a Think Tank on Advancing Gastric Cancer Prevention, with participation of over 200 global leaders from academia, clinical practice, and industry as well as patient advocates to exchange knowledge, lived experiences, and discuss future research opportunities. This commentary summarizes the Think Tank presentations and discussions of key existing evidence as well as challenges and opportunities for the prevention and control of this preventable disease. Primary prevention discussions focused on the use of the screen-and-treat strategy for Helicobacter pylori eradication. Secondary prevention discussions included endoscopic screening and surveillance of advanced gastric precancerous lesions. Primary conclusions for gastric cancer prevention and control included the need for (1) developing large-scale study resources that optimize the ability to conduct research with potential clinical translation applications; (2) strengthening and building community-public health-academic partnerships to enhance research; and (3) leveraging evidence-based strategies developed in high-risk East Asian countries to high-risk subgroups in low- and moderate-risk countries including the United States. There was overwhelming agreement that given the current state of gastric cancer incidence and survival in the United States, novel strategies to control the carcinogenic effects of H. pylori and to improve detection of precursors are the key to substantially reducing the burden of this disease.