Stomach cancer screening
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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%.
- Upper endoscopy is more sensitive than other screening studies. It allows direct visualization of the gastric mucosa and allows for obtaining biopsies.
- Barium radiographs can identify malignant gastric ulcers, infiltrating lesions, and some early gastric cancers.
- Barium studies can be false negative in 50 percent of cases and the sensitivity of a barium study may be 14 percent.
- In patients with linitis plastica, a barium study may be superior to upper endoscopy.
Sensitivity of tests
- Both studies had a specificity of 96%.
- The upper endoscopy sensitivity in detecting a localized gastric cancer is higher than upper GI series.
- Universal screening is recommended in countries with a high incidence of gastric cancer such as East Asian countries.
- 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
- Screening interval is recommended to be every two years but may be widened to a three-year interval without significant effect.
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.
- Individuals at increased risk for gastric cancer include those patients having the following:
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