Dear Editor

I would like to express my gratitude for the publication of the article "Factors Associated with Knowledge on Gastric Cancer Prevention in Patients at a Hospital in Lima - Peru, 2017"¹. It is encouraging to see research addressing crucial public health issues such as gastric cancer (GC) prevention, particularly in the Peruvian context.

Cancer is a devastating disease that affects millions of people worldwide, and GC is no exception.

In 2020 alone, GC was the 5th most prevalent cancer with an incidence of 1,100,000 new cases and 769,000 deaths globally². Although the numbers have been decreasing in recent years, the efforts and measures applied by each nation are not enough to prevent hundreds of thousands of deaths³.

Among the factors associated with GC, tobacco consumption is one of the most relevant after Helicobacter pylori infection⁴.

The search for risk factors, particularly tobacco consumption, has been the subject of numerous studies demonstrating the correlation and the extent of the effect that tobacco consumption has on the development of GC.

This association between tobacco consumption and GC should not be overlooked, especially in a country like ours, where the incidence of GC remains alarmingly high. In 2013, there was a mortality rate of 11.4 per 100,000 inhabitants⁵. A recent journalistic article mentioned that in Peru, new GC cases amount to 6,300 and deaths reach 4,979, representing 80% of cases, making it the cancer with the highest mortality⁶. These figures remain alarmingly high; therefore, GC in Peru is a reality that demands an urgent response from health authorities.

While the article mentions factors such as lack of employment, limited internet access, and socioeconomic level as determinants of knowledge about prevention, it is crucial to recognize that smoking also plays a vital role in this issue.

Under the title "Is it Enough to Know that Tobacco Consumption is Associated with Gastric Cancer?"

I would like to emphasize the importance of prioritizing gastric cancer prevention. For this, it seems necessary to explore more dimensions of this risk factor, such as the amount of tobacco consumed per day, whether one is a current or former tobacco user, and whether one is an active or passive smoker. This way, efforts can be better focused on funding awareness and prevention campaigns with a more significant impact on the population. This includes not only educating about the risks of smoking but also promoting healthy lifestyles and facilitating access to preventive healthcare services and early detection.

It is imperative to allocate adequate economic resources to address this problem comprehensively, from health promotion to specialized medical care. Only through a coordinated and committed approach can we hope to reduce the burden of GC and improve health outcomes for the population.