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Malignant Neoplasm of the Stomach B002

Last amended 
1 August 2019
Current RMA Instruments
Reasonable Hypothesis SOP
58 of 2014 as amended
Balance of Probabilities SOP
59 of 2014 as amended
Changes from previous Instruments

SOP Bulletin 176

ICD Coding
  • ICD-9-CM Codes: 151
  • ICD-10-AM Codes: C16
Brief description

Gastric cancer is one of the most common cancers worldwide, but is less common in Western countries. There are a number of sub-types of the disease.  The SOP covers primary epithelial cancers of the cardia, body, antrum and pyloris of the stomach.

Confirming the diagnosis

Information on histology (from biopsy, an excised specimen, or autopsy) is required to confirm the diagnosis and apply the SOP.  Information on whether the primary site is the cardia of the stomach (near the oesophagus), or the rest of the stomach, will be needed to apply some of the SOP factors.

The relevant medical specialist is an oncologist, general surgeon, or gastroenterologist.

Diagnoses covered by SOP
  • adeno-, adenosquamous-, chorio-, diffuse-, intestinal-, squamous-, poorly differentiated- and undifferentiated- carcinoma of the stomach; (including mucinous, papillary, signet ring and tubular adenocarcinoma of the stomach)
  • carcinoma of the (gastric) cardia; gastric carcinoma
  • carcinoma of the stomach
  • linitis plastica;
Conditions excluded from SOP
  • carcinoid of the stomach#
  • soft tissue sarcoma of the stomach*
  • non-Hodgkin lymphoma of the stomach*
  • Hodgkin’s lymphoma of the stomach*
  • MALT lymphoma of the stomach - non-Hodgkin lymphoma SOP
  • Secondary/metastatic cancer/carcinoma involving the stomach (code to primary cancer site)

* another SOP applies

# Non-SOP condition

Clinical onset

The condition typically presents at a late stage.  Weight loss and persistent abdominal pain are the most common symptoms. Other presentations can include dysphagia (difficulty swallowing) and nausea. 

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Most people present with advanced, uncurable disease and have a poor prognosis even with treatment.