Stomach cancer screening
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2] Mohammed Abdelwahed M.D[3]
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Overview
The two main modalities for gastric cancer screening are upper endoscopy and contrast radiography. Universal screening is recommended in countries with a high incidence of gastric cancer such as East Asian countries. In areas of low gastric cancer incidence, screening for gastric cancer with upper endoscopy should be reserved specifically for high-risk subgroups. Upper endoscopy has a sensitivity of 69 % and upper GI series has a sensitivity of 37%. Both studies have a specificity of 96%.
Screening
The two main modalities for gastric cancer screening are upper endoscopy and contrast radiography.
Upper endoscopy
- Upper endoscopy is more sensitive than other screening studies. It allows direct visualization of the gastric mucosa and allows for obtaining biopsies.[1]
Contrast radiography
- Barium radiographs can identify malignant gastric ulcers, infiltrating lesions, and some early gastric cancers.[2]
- Barium studies can be false negative in 50 percent of cases and the sensitivity of a barium study may be 14 percent.[3]
- In patients with linitis plastica, a barium study may be superior to upper endoscopy.
Sensitivity of tests
- Upper endoscopy has a sensitivity of 69 % and upper GI series has a sensitivity of 37%.
- Both studies had a specificity of 96%.
- The upper endoscopy sensitivity in detecting a localized gastric cancer is higher than upper GI series.[4]
Screening Strategies
Universal screening
- Universal screening is recommended in countries with a high incidence of gastric cancer such as East Asian countries.[5]
- In Japan, population-based screening for gastric cancer is recommended for individuals older than 50 years with conventional double-contrast barium radiograph with photofluorography every year or upper endoscopy every two to three years[6]
- Screening interval is recommended to be every two years but may be widened to a three-year interval without significant effect.[7]
Selective screening of high-risk subgroups
- In areas of low gastric cancer incidence, screening for gastric cancer with upper endoscopy should be reserved for specific high-risk subgroups.[8]
- Individuals at increased risk for gastric cancer include those patients having the following:
References
- ↑ Pisani P, Oliver WE, Parkin DM, Alvarez N, Vivas J (1994). "Case-control study of gastric cancer screening in Venezuela". Br J Cancer. 69 (6): 1102–5. PMC 1969457. PMID 8198977.
- ↑ Dooley CP, Larson AW, Stace NH, Renner IG, Valenzuela JE, Eliasoph J; et al. (1984). "Double-contrast barium meal and upper gastrointestinal endoscopy. A comparative study". Ann Intern Med. 101 (4): 538–45. PMID 6383166.
- ↑ Longo WE, Zucker KA, Zdon MJ, Modlin IM (1989). "Detection of early gastric cancer in an aggressive endoscopy unit". Am Surg. 55 (2): 100–4. PMID 2916797.
- ↑ Choi KS, Jun JK, Suh M, Park B, Noh DK, Song SH; et al. (2015). "Effect of endoscopy screening on stage at gastric cancer diagnosis: results of the National Cancer Screening Programme in Korea". Br J Cancer. 112 (3): 608–12. doi:10.1038/bjc.2014.608. PMC 4453643. PMID 25490528.
- ↑ Llorens P (1991). "Gastric cancer mass survey in Chile". Semin Surg Oncol. 7 (6): 339–43. PMID 1759081.
- ↑ Choi IJ (2014). "Endoscopic gastric cancer screening and surveillance in high-risk groups". Clin Endosc. 47 (6): 497–503. doi:10.5946/ce.2014.47.6.497. PMC 4260096. PMID 25505714.
- ↑ Park CH, Kim EH, Chung H, Lee H, Park JC, Shin SK; et al. (2014). "The optimal endoscopic screening interval for detecting early gastric neoplasms". Gastrointest Endosc. 80 (2): 253–9. doi:10.1016/j.gie.2014.01.030. PMID 24613579.
- ↑ Tersmette AC, Goodman SN, Offerhaus GJ, Tersmette KW, Giardiello FM, Vandenbroucke JP; et al. (1991). "Multivariate analysis of the risk of stomach cancer after ulcer surgery in an Amsterdam cohort of postgastrectomy patients". Am J Epidemiol. 134 (1): 14–21. PMID 1853856.