Stomach cancer is the second most common cancer worldwide. Considerable knowledge about potentially causal factors has been gathered during the past few decades. Helicobacter pylori, the strongest and most important risk factor, is likely to become the first target in future prevention strategies. A deeper understanding of effect-modifying factors or circumstances in the microorganism, in the host, and/or in the environment may help us to design precisely targeted interventions. Dietary factors, particularly the intake of antioxidant-rich fruits and vegetables, are likely to be important, albeit perhaps somewhat overrated in older case-control data. New insights in bacterial and human genetics may enable us to focus even more precisely on the relevant high-risk groups. They may also allow selective prevention of infections predestined to trigger the carcinogenic process. To achieve these goals, epidemiologists, gastroenterologists, pathologists, tumor biologists, microbiologists, geneticists, and biochemists need to join forces in a coordinated effort.
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