How to Improve the Efficacy of Gastric Cancer Screening?

Abstract

Abstract Purpose of review This review article aims to provide an overview of existing and emerging screening strategies for gastric cancer and discuss potential measures to improve its efficacy in countries with different risk profiles for the disease. Recent findings Recent developments in endoscopic technology, including image enhancement and computer-guided diagnosis, can improve further early cancer detection in countries with primary endoscopic screening. Moreover, accumulating data on upper endoscopy quality underlines the pivotal role of appropriate examination time and the vital role of premedication (sedation, defoaming agents, and antispasmodics). In regions with low-to-intermediate incidence, the “test-and-treat” approach for H. pylori infection seems feasible for gastric cancer screening and prevention. Possibly, a family-based approach to test for the condition within family households could further improve the efficacy of this approach. In addition, other non-invasive methods to identify at-risk individuals are being evaluated, such as breath testing, serological markers, and circulating tumor cells. Summary Gastric cancer screening practices vary widely globally based on incidence, local healthcare facilities, and funding. However, wide-ranged screening programs for gastric cancer may be feasible even in countries with low-to-intermediate incidence if the approach is tailored towards the local disease burden and focused on the pre-selection of at-risk individuals.