Frequency of Familial Gastric Cancer

About 80–90 % of gastric cancer appears as sporadic form, and 10–20 % with a familial setting; however, considering the different worldwide countries, this frequency appears extremely variable. In high risk-area for gastric tumors this incidence results higher than in low-risk zones. Conversely, the frequency of CDH1 germline mutations is contrasting with the incidence of familial gastric carcinoma. Exploring these considerations, in high-risk area it seems that environmental factors exercise a stronger mechanism in the familial gastric carcinogenesis. This data could open new approaches in the gastric cancer prevention test; before to candidate a proband for the CDH1 genetic screening, geographic variability, alongside the family history should be considered.