New Hope for Stomach Cancer: Early Detection on the Rise, Outcomes Poised to Improve

In a promising shift for one of the deadliest forms of cancer, researchers are now identifying stomach tumors at much earlier stages—offering patients a better shot at survival and challenging long-held clinical expectations.

For decades, gastric cancer has often gone unnoticed until it’s too late, frequently discovered only after it’s spread beyond the stomach. But new data presented at Digestive Disease Week, a global conference for gastrointestinal medicine, suggests that modern imaging technology is flipping that narrative.

“We’re witnessing a quiet revolution,” said Dr. Mohamed Tausif Siddiqui, a gastroenterology fellow at the Cleveland Clinic and lead author of the study. “Stomach cancers that once eluded us until they were advanced are now being caught while still localized. That’s a game-changer.”

Siddiqui and his team combed through data from the National Cancer Institute’s SEER-22 registry and found a marked rise in the detection of early-stage stomach cancers between 2004 and 2021. During the same period, diagnoses of late-stage cases showed a decline.

In 2004, early-stage gastric cancer was found in 1.94 per 100,000 people. By 2021, that figure had grown to 2.97 per 100,000—surpassing late-stage diagnoses, which fell to 2.35 per 100,000. It’s the first time in U.S. data that early-stage cases have overtaken advanced ones, according to Siddiqui.

What’s driving the shift? A new generation of endoscopes equipped with high-definition imaging and zoom capabilities is giving clinicians a far clearer picture of the upper gastrointestinal tract. Small, easily missed lesions are now coming into focus.

“Previously, many patients were diagnosed only after the cancer had metastasized,” Siddiqui explained. “Now we’re identifying tumors when they’re still confined to the stomach lining. That opens the door to less invasive treatments.”

In countries like Japan and South Korea, routine stomach cancer screening has long been the norm—spurred by higher incidence rates. South Koreans aged 40 to 74 undergo endoscopic exams every two years. Experts say the U.S. could benefit from similar guidelines, especially given shifting demographics.

A second study presented by Cleveland Clinic researchers found that diagnoses are increasing among adults under 50—a trend that concerns oncologists. Dr. Michael Gibson of Vanderbilt University Medical Center, who specializes in esophagogastric cancer, called the rise in young adult cases “worrisome,” though he noted the silver lining: “We’re finding these cancers at earlier stages than ever before.”

Despite the growing list of risk factors—ranging from Helicobacter pylori infection to smoking, obesity, and family history—many patients have few or no symptoms until the disease is advanced. Early signs, when they appear, can be vague: persistent acid reflux, unexplained abdominal pain, burping, anemia, or weight loss.

Currently, there are no universal stomach cancer screening guidelines in the U.S. Most patients are tested only if symptoms develop or if they have a family history. But with more early-stage tumors now being identified, clinicians and researchers are advocating for a reassessment of when and how people are screened.

“This could be a turning point,” said Dr. Ji Yoon Yoon, a gastroenterologist at Mount Sinai in New York who was not involved in the study. “When most cases are caught early, we’re not just detecting cancer—we’re improving survival.”

Localized stomach cancers, when detected early, can often be treated with less invasive methods, such as endoscopic surgery. In contrast, advanced cases typically require partial or full removal of the stomach and aggressive treatment. The overall five-year survival rate for stomach cancer remains low at 36%, but for localized cases, that figure jumps to 77%.

Dr. Ryan Moy, a gastrointestinal oncologist at Columbia University, believes that earlier detection will ultimately translate into better long-term outcomes—but adds a word of caution: “We need more follow-up to confirm whether this trend in early diagnosis actually results in more lives saved.”

Still, the mood among many in the medical community is one of cautious optimism. As Siddiqui put it: “For the first time in a long time, we’re seeing signs that stomach cancer doesn’t have to be a death sentence.”