screening for gastric cancer
Screening for stomach cancer
- in the most recent guideline about stomach cancer published by the British Society of Gastroenterology (BSG), endoscopic screening for gastric adenocarcinoma in the UK population is not recommended(1). However, there was a consensus that screening could be considered for a sub group of the population with multiple risk factors for developing the condition such as people who are over the age of 50, male, with a family history of gastric adenocarcinoma and those who smoke and are obese (1)
Three pre-malignant stages have been identified that precede the development of gastric adenocarcinoma, these are atrophic gastritis; intestinal metaplasia and dysplasia.
- accurately identifying and treating people with these pre-malignant stages of the condition is important in improving survival rates (2)
- some countries with a high incidence of gastric adenocarcinoma such as Japan (27.5 per 100,000 population in 2018) (3)and South Korea (39.6 per 100,000 population in 2018) (3) screen their populations for the pre-malignant stages of the condition and there is some evidence that these screening programmes have improved survival (2,4)
- incidence rate of stomach cancer in Japan and South Korea has been decreasing over past decades in a similar way to countries who have not implemented screening such as the UK. For example, in Japan the incidence of stomach cancer in males was 79.2 per 100,000 population in 1983 and had fallen to 70.2 in 1993 and 51.0 in 2002 (5).
There are a range of different types of screening tests to identify people at high risk of developing stomach cancer. Procedures to visually detect stomach abnormalities using upper endoscopy or contrast radiography with barium meal are used in screening programmes in South Korea and Japan.
- Banks M, Graham D, Jansen M, et al British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma Gut 2019;68:1545-1575.
- Hamashima C. Ogoshi K. Okamoto M. et al. A community-based, case-control study evaluating mortality reduction from gastric cancer by endoscopic screening in Japan. PLoS ONE. 2013, 8(11):e79088.
- Bray F, Ferlay J Soerjomataram I, Siegel R, Torre L, Jemel A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries Cancer J Clin. 2018; 68:394-424.
- Zhang X, Li M, Chen S, Hu J, Guo Q, Lui R et al. Endoscopic Screening in Asian Countries Is Associated With Reduced Gastric Cancer Mortality: A Meta-analysis and Systematic Review Gastroenterology 2018;155:347–354.
- Lin JT. Screening of Gastric Cancer: Who, When, and How Clinical Gastroenterology and Hepatology 2014;12:135–138.
Last edited 11/2020 and last reviewed 11/2020