A 55-year-old man from Ningbo, identified only as Mr. Su, sought medical attention after enduring nearly a month of persistent diarrhoea—a symptom that ultimately led to the discovery of five separate early-stage cancerous lesions in his digestive system. The case, reported by Zhejiang University School of Medicine’s First Affiliated Hospital, highlights the silent progression of digestive tract cancers and the critical role of dietary habits in disease risk.
The Diagnosis and Findings
Following a comprehensive gastroscopy and colonoscopy, physicians identified malignant growths in five distinct locations: one on the upper posterior wall of the stomach, two in the thoracic segment of the oesophagus, one on the greater curvature of the gastric antrum, and one near the gastro-oesophageal junction. Despite the alarming number of lesions, all were classified as early-stage cancers, offering a significantly better prognosis than advanced disease.
Lifestyle Factors Under Scrutiny
Mr. Su’s daily routine revealed two prominent risk factors: a long-standing habit of smoking and a strong preference for pickled and salt-preserved foods, such as zhacai (pickled mustard stem) and salted crab. These items are high in nitrates and sodium, which have been consistently linked to an elevated risk of gastric and oesophageal malignancies. Experts note that chronic consumption of such foods, combined with tobacco use, creates a particularly hostile environment for the digestive mucosa.
Expert Insight: Why Early Detection Matters
Dr. Ji Feng, chief physician in the Department of Gastroenterology at the First Affiliated Hospital of Zhejiang University, cautioned that early-stage digestive cancers often produce no obvious symptoms. Mr. Su’s diarrhoea was a relatively late and non-specific indicator. Dr. Ji recommends that individuals aged 40 and above, as well as those with any of the following risk factors, undergo an annual endoscopic examination:
- Family history of digestive tract cancer
- Heavy smoking (more than 20 pack-years)
- Regular heavy alcohol consumption
- Habitual consumption of very hot foods or beverages
- Frequent intake of pickled, salted, or smoked foods
- Rapid or irregular eating patterns
For the general population, Dr. Ji advises a screening colonoscopy or gastroscopy every two to three years as a preventive measure.
Treatment and Prognosis
Mr. Su underwent endoscopic submucosal dissection (ESD), a minimally invasive procedure that removes early-stage lesions while preserving the surrounding healthy tissue. He was discharged from hospital just two days after the operation. However, his medical team stressed that, given the widespread mucosal damage in his stomach and oesophagus, he remains at elevated risk for new tumour formation. Regular follow-up gastroscopies will be essential for long-term monitoring.
The survival statistics underscore the urgency of early detection: according to the hospital, the cure rate for early-stage digestive cancers exceeds 90 percent. In contrast, when these cancers are diagnosed at an intermediate or advanced stage, the five-year survival rate plummets to below 30 percent.
Broader Implications for Public Health
This case serves as a stark reminder that dietary habits are among the most modifiable risk factors for digestive cancers. Beyond pickled foods, medical research has identified other contributors, including consumption of scalding-hot items, spicy and fried foods, high-salt meals, and mould-contaminated ingredients. Irregular meal times and eating too quickly further compound the risk by repeatedly irritating the oesophageal and gastric linings.
For readers in Hong Kong and beyond, where pickled vegetables and preserved seafood are staples in many diets, the message is clear: balancing culinary traditions with moderation can be life-saving. Those who fall into high-risk categories—especially smokers and long-term consumers of salted foods—are urged to speak with their doctor about scheduling a screening endoscopy.
Actionable Takeaway
If you experience unexplained digestive symptoms—such as persistent diarrhoea, difficulty swallowing, chronic heartburn, or unintended weight loss—do not dismiss them. Early intervention can transform a potentially fatal diagnosis into a treatable condition. For more information on gastrointestinal health and cancer prevention, consult your healthcare provider or refer to reputable resources such as the Hong Kong Cancer Fund or the Department of Health’s colorectal cancer screening programme.