Stomach cancer screening: Difference between revisions
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{{Stomach cancer}} | {{Stomach cancer}} | ||
==Overview== | ==Overview== | ||
The two main modalities for gastric cancer screening are [[upper endoscopy]] and [[Contrast medium|contrast]] radiography. In countries with a high [[incidence]] of gastric cancer such as east asia countaries, universal screening is recommended. In areas of low gastric cancer [[incidence]], [[screening]] for gastric cancer with '''[[upper endoscopy]]''' should be reserved for specific high-risk subgroups. The [[Sensitivity (tests)|sensitivity rates]] for [[upper endoscopy]] were 69 % and [[Upper gastrointestinal series|upper GI series]] were 37%. Both studies had a [[Specificity (tests)|specificity]] of 96%. | |||
==Screening cancer== | ==Screening cancer== | ||
The two main modalities for gastric cancer screening are upper endoscopy and contrast radiography. | The two main modalities for gastric cancer screening are [[upper endoscopy]] and [[Contrast medium|contrast]] radiography. | ||
'''Upper endoscopy''' | '''Upper endoscopy''' | ||
* Upper endoscopy is more sensitive than other screening studies. It allows direct visualization of the gastric mucosa and obtaining biopsies.<ref name="pmid8198977">{{cite journal| author=Pisani P, Oliver WE, Parkin DM, Alvarez N, Vivas J| title=Case-control study of gastric cancer screening in Venezuela. | journal=Br J Cancer | year= 1994 | volume= 69 | issue= 6 | pages= 1102-5 | pmid=8198977 | doi= | pmc=1969457 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8198977 }}</ref> | * [[Upper endoscopy]] is more sensitive than other screening studies. It allows direct visualization of the gastric [[Mucosal|mucosa]] and obtaining [[Biopsy|biopsies]].<ref name="pmid8198977">{{cite journal| author=Pisani P, Oliver WE, Parkin DM, Alvarez N, Vivas J| title=Case-control study of gastric cancer screening in Venezuela. | journal=Br J Cancer | year= 1994 | volume= 69 | issue= 6 | pages= 1102-5 | pmid=8198977 | doi= | pmc=1969457 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8198977 }}</ref> | ||
'''Contrast radiography''' | '''Contrast radiography''' | ||
* Barium radiographs can identify malignant gastric ulcers, infiltrating lesions, and some early gastric cancers.<ref name="pmid6383166">{{cite journal| author=Dooley CP, Larson AW, Stace NH, Renner IG, Valenzuela JE, Eliasoph J et al.| title=Double-contrast barium meal and upper gastrointestinal endoscopy. A comparative study. | journal=Ann Intern Med | year= 1984 | volume= 101 | issue= 4 | pages= 538-45 | pmid=6383166 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6383166 }}</ref> | * [[Barium meal|Barium radiographs]] can identify malignant gastric ulcers, infiltrating lesions, and some early gastric cancers.<ref name="pmid6383166">{{cite journal| author=Dooley CP, Larson AW, Stace NH, Renner IG, Valenzuela JE, Eliasoph J et al.| title=Double-contrast barium meal and upper gastrointestinal endoscopy. A comparative study. | journal=Ann Intern Med | year= 1984 | volume= 101 | issue= 4 | pages= 538-45 | pmid=6383166 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6383166 }}</ref> | ||
* Barium studies can be false negative in 50 percent of cases. On the other hand, the sensitivity of a barium study may be 14 percent.<ref name="pmid2916797">{{cite journal| author=Longo WE, Zucker KA, Zdon MJ, Modlin IM| title=Detection of early gastric cancer in an aggressive endoscopy unit. | journal=Am Surg | year= 1989 | volume= 55 | issue= 2 | pages= 100-4 | pmid=2916797 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2916797 }}</ref> | * Barium studies can be false negative in 50 percent of cases. On the other hand, the [[Sensitivity (tests)|sensitivity]] of a [[Barium meal|barium study]] may be 14 percent.<ref name="pmid2916797">{{cite journal| author=Longo WE, Zucker KA, Zdon MJ, Modlin IM| title=Detection of early gastric cancer in an aggressive endoscopy unit. | journal=Am Surg | year= 1989 | volume= 55 | issue= 2 | pages= 100-4 | pmid=2916797 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2916797 }}</ref> | ||
* In patients with linitis plastica, barium study may be superior to upper endoscopy. | * In patients with [[linitis plastica]], barium study may be superior to [[upper endoscopy]]. | ||
'''Effectiveness''' | '''Effectiveness''' | ||
* The sensitivity rates for upper endoscopy were 69 % and upper GI series were 37%. | * The [[Sensitivity (tests)|sensitivity rates]] for [[upper endoscopy]] were 69 % and [[Upper gastrointestinal series|upper GI series]] were 37%. | ||
* Both studies had a specificity of 96%. | * Both studies had a [[Specificity (tests)|specificity]] of 96%. | ||
* The upper endoscopy sensitivity in detecting a localized gastric cancer is higher than upper GI series.<ref name="pmid25490528">{{cite journal| author=Choi KS, Jun JK, Suh M, Park B, Noh DK, Song SH et al.| title=Effect of endoscopy screening on stage at gastric cancer diagnosis: results of the National Cancer Screening Programme in Korea. | journal=Br J Cancer | year= 2015 | volume= 112 | issue= 3 | pages= 608-12 | pmid=25490528 | doi=10.1038/bjc.2014.608 | pmc=4453643 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25490528 }}</ref> | * The [[upper endoscopy]] [[Sensitivity (tests)|sensitivity]] in detecting a localized gastric cancer is higher than [[Upper gastrointestinal series|upper GI series]].<ref name="pmid25490528">{{cite journal| author=Choi KS, Jun JK, Suh M, Park B, Noh DK, Song SH et al.| title=Effect of endoscopy screening on stage at gastric cancer diagnosis: results of the National Cancer Screening Programme in Korea. | journal=Br J Cancer | year= 2015 | volume= 112 | issue= 3 | pages= 608-12 | pmid=25490528 | doi=10.1038/bjc.2014.608 | pmc=4453643 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25490528 }}</ref> | ||
'''SCREENING STRATEGIES''' | '''SCREENING STRATEGIES''' | ||
'''Universal screening''' | '''Universal screening''' | ||
* In countries with a high incidence of gastric cancer such as east asia countaries, universal screening is recommended.<ref name="pmid1759081">{{cite journal| author=Llorens P| title=Gastric cancer mass survey in Chile. | journal=Semin Surg Oncol | year= 1991 | volume= 7 | issue= 6 | pages= 339-43 | pmid=1759081 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1759081 }}</ref> | * In countries with a high [[incidence]] of gastric cancer such as east asia countaries, universal screening is recommended.<ref name="pmid1759081">{{cite journal| author=Llorens P| title=Gastric cancer mass survey in Chile. | journal=Semin Surg Oncol | year= 1991 | volume= 7 | issue= 6 | pages= 339-43 | pmid=1759081 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1759081 }}</ref> | ||
* 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<ref name="pmid25505714">{{cite journal| author=Choi IJ| title=Endoscopic gastric cancer screening and surveillance in high-risk groups. | journal=Clin Endosc | year= 2014 | volume= 47 | issue= 6 | pages= 497-503 | pmid=25505714 | doi=10.5946/ce.2014.47.6.497 | pmc=4260096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25505714 }}</ref> | * 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<ref name="pmid25505714">{{cite journal| author=Choi IJ| title=Endoscopic gastric cancer screening and surveillance in high-risk groups. | journal=Clin Endosc | year= 2014 | volume= 47 | issue= 6 | pages= 497-503 | pmid=25505714 | doi=10.5946/ce.2014.47.6.497 | pmc=4260096 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25505714 }}</ref> | ||
* Screening interval is recommended to be every two years but may be widened to a three-year rather than a two-year interval without significant effect.<ref name="pmid24613579">{{cite journal| author=Park CH, Kim EH, Chung H, Lee H, Park JC, Shin SK et al.| title=The optimal endoscopic screening interval for detecting early gastric neoplasms. | journal=Gastrointest Endosc | year= 2014 | volume= 80 | issue= 2 | pages= 253-9 | pmid=24613579 | doi=10.1016/j.gie.2014.01.030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24613579 }}</ref> | * Screening interval is recommended to be every '''two years''' but may be widened to a '''three-year''' rather than a two-year interval without significant effect.<ref name="pmid24613579">{{cite journal| author=Park CH, Kim EH, Chung H, Lee H, Park JC, Shin SK et al.| title=The optimal endoscopic screening interval for detecting early gastric neoplasms. | journal=Gastrointest Endosc | year= 2014 | volume= 80 | issue= 2 | pages= 253-9 | pmid=24613579 | doi=10.1016/j.gie.2014.01.030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24613579 }}</ref> | ||
'''Selective screening of high-risk subgroups''' | '''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.<ref name="pmid1853856">{{cite journal| author=Tersmette AC, Goodman SN, Offerhaus GJ, Tersmette KW, Giardiello FM, Vandenbroucke JP et al.| title=Multivariate analysis of the risk of stomach cancer after ulcer surgery in an Amsterdam cohort of postgastrectomy patients. | journal=Am J Epidemiol | year= 1991 | volume= 134 | issue= 1 | pages= 14-21 | pmid=1853856 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1853856 }}</ref> | * In areas of low gastric cancer [[incidence]], [[screening]] for gastric cancer with '''[[upper endoscopy]]''' should be reserved for specific high-risk subgroups.<ref name="pmid1853856">{{cite journal| author=Tersmette AC, Goodman SN, Offerhaus GJ, Tersmette KW, Giardiello FM, Vandenbroucke JP et al.| title=Multivariate analysis of the risk of stomach cancer after ulcer surgery in an Amsterdam cohort of postgastrectomy patients. | journal=Am J Epidemiol | year= 1991 | volume= 134 | issue= 1 | pages= 14-21 | pmid=1853856 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1853856 }}</ref> | ||
*Individuals at increased risk for gastric cancer include those with the following: | *Individuals at increased risk for gastric cancer include those with the following: | ||
**Gastric adenomas | **Gastric [[Adenoma|adenomas]] | ||
**Pernicious anemia | **[[Pernicious anemia]] | ||
**Gastric intestinal metaplasia | **Gastric [[intestinal]] [[metaplasia]] | ||
**Familial adenomatous polyposis | **[[Familial adenomatous polyposis]] | ||
**Lynch syndrome | **[[Lynch syndrome]] | ||
**Peutz-Jeghers syndrome | **[[Peutz-Jeghers syndrome]] | ||
**Juvenile polyposis syndrome | **[[Juvenile polyposis syndrome]] | ||
==References== | ==References== | ||
Revision as of 22:21, 21 November 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
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Overview
The two main modalities for gastric cancer screening are upper endoscopy and contrast radiography. In countries with a high incidence of gastric cancer such as east asia countaries, universal screening is recommended. In areas of low gastric cancer incidence, screening for gastric cancer with upper endoscopy should be reserved for specific high-risk subgroups. The sensitivity rates for upper endoscopy were 69 % and upper GI series were 37%. Both studies had a specificity of 96%.
Screening cancer
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 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. On the other hand, the sensitivity of a barium study may be 14 percent.[3]
- In patients with linitis plastica, barium study may be superior to upper endoscopy.
Effectiveness
- The sensitivity rates for upper endoscopy were 69 % and upper GI series were 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
- In countries with a high incidence of gastric cancer such as east asia countaries, universal screening is recommended.[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 rather than a two-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 with 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.