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Almost one million (951 600) new cases of gastric cancer were diagnosed globally in 2012, resulting in∼ 723 100 deaths [1]. Of these∼ 140 000 cases and∼ 107 000 deaths occurred in Europe [2]. Gastric cancer displays significant global variation in incidence; the highest rates are seen in Eastern Asia, Eastern Europe and South America, with lower rates in North America and Western Europe. A gradual decline in the incidence of gastric cancer has been observed in Western Europe and North America over the past 60 years and more recent declines in high-prevalence countries have also become apparent. This is epidemiologically distinct from the relative increase in tumours of the gastroesophageal junction, which are discussed in a separate guideline document.

Risk factors for gastric cancer include male gender (incidence is twice as high), Helicobacter pylori infection, tobacco use, atrophic gastritis, partial …