Family history of stomach cancer: risk, symptoms and what to do

Stomach cancer, also called gastric cancer, starts in the lining of the stomach. The NHS says that anyone can get it and that it is not always clear what causes it. A family history means that a close blood relative has had the disease.

The NHS specifically lists having a brother, sister or parent who has had stomach cancer as a factor that may make you more likely to get it. That does not mean the disease is inevitable. Most people with an affected relative do not develop stomach cancer, but the information is worth sharing with your GP, especially alongside other factors on the list.

Part of the reason risk clusters in families is shared exposures, such as infection with Helicobacter pylori or similar diet and lifestyle, and part is inherited genetic susceptibility. The NHS page does not separate these, and it is not usually possible to say which applies in an individual family without specialist assessment.

The NHS lists the following as things that may make stomach cancer more likely: being over the age of 50, being a man, having had infection with Helicobacter pylori (H. pylori), and certain stomach conditions such as long-term severe acid reflux, gastritis or pernicious anaemia, which affects your immune system. It adds that many stomach cancers are also linked to lifestyle.

H. pylori is a bacterium that lives in the stomach lining. It often causes no problems, and the NHS points to Cancer Research UK for more on the link between H. pylori and stomach cancer. If you have a family history and also have a history of H. pylori, it is worth mentioning both to your GP.

Work can matter too. The NHS advises wearing protective clothes and masks if you work in a job where you are exposed to harmful chemicals, such as in the rubber industry or coal mining.

The NHS says stomach cancer symptoms can affect digestion, and that others affect the body more generally. None of them proves cancer, and most people with them have a more ordinary cause.

• Heartburn or acid reflux.

• Problems swallowing (dysphagia).

• Feeling or being sick, or burping a lot, as with indigestion.

• Feeling full very quickly when eating.

• Loss of appetite or losing weight without trying to.

• A lump or pain at the top of your tummy.

• Feeling tired or having no energy, and darker than usual poo.

The NHS advises seeing a GP if you have problems swallowing, a lump in your tummy, weight loss that is not explained by changes in diet or exercise, other symptoms of stomach cancer that get worse or do not get better after 3 weeks, or a digestive condition that is not improving after 3 weeks of your usual treatments.

It says to get advice from NHS 111 if you have been vomiting for more than 2 days, or if you have symptoms you are worried about and are not sure where to get help. People who live with reflux sometimes get used to their symptoms, so the NHS specifically asks them to be checked if symptoms change, get worse or do not feel normal.

With a family history, a lower threshold for mentioning symptoms is sensible. Tell the GP about your relative at the first appointment, because it can influence how quickly you are referred.

A GP or specialist will probably refer you for a gastroscopy, a type of endoscopy. The NHS says a long, thin, flexible tube with a small camera is passed through your mouth, down your throat and into your stomach, and a small sample of cells (a biopsy) may be collected for laboratory testing. The test should take around 10 to 15 minutes, should not be painful but can be uncomfortable, and you may be offered throat spray or sedation.

Results of a gastroscopy and biopsy should reach you within 2 weeks, according to the NHS, and a longer wait does not definitely mean anything is wrong. If cancer is diagnosed, further tests such as an ultrasound, CT or PET scan or a laparoscopy help the specialists work out the size and stage and plan treatment. A clinical nurse specialist is your main point of contact.

The NHS suggests trying to quit smoking, losing weight if you are overweight, cutting down on salt, avoiding more than 14 units of alcohol a week and eating at least 5 portions of a variety of fruit and vegetables every day. These steps are sensible whatever your family history.

The NHS pages on stomach cancer describe assessment through symptoms and GP referral rather than a routine screening programme, so what happens next depends on your symptoms and on your GP's judgement of your risk. Some people choose a private gastroscopy for reassurance. It can be useful if symptoms are present, but a normal test does not remove the need to report new symptoms, and your GP can help you decide whether it is appropriate.