Study reveals optimal interval for stomach cancer screening

A new study has determined how often people should get screened for gastric or stomach cancer in high-risk regions of the world. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings could help reduce deaths from gastric cancer, which is the second most common cause of cancer-related mortality.

Although the incidence of gastric cancer has decreased substantially in the western part of the world, the disease is still common in areas such as Eastern Asia, including Korea, Japan, and China.

Gastric cancer patients' prognosis strongly depends on the stage of the disease, or how advanced it is, at the time of diagnosis. In other words, early detection and treatment can save lives.

Gastric cancer screening is often done by upper endoscopy—using a tiny camera at the end of a long, flexible tube to look at the upper digestive system. To see how often this screening technique should be done to detect gastric cancer at an early stage, Il Ju Choi, MD, PhD, of the National Cancer Center in Korea, and his colleagues studied 2,485 patients who had been diagnosed with gastric cancer at their institution. The researchers divided the patients into the following seven groups based on the interval between the endoscopy that detected gastric cancer and the endoscopy that preceded it: one year, two years, three years, four years, five years, more than five years, and never-screened. Currently, screening every two years is recommended in Korea for individuals who are aged 40 years or older.

The investigators found that gastric cancer stages were similar for screening intervals between one and three years; however, the cancer stage at diagnosis was significantly higher at screening intervals of four years or more.

"The optimal screening strategy appears to be every three years. Gastric cancers are likely to become more advanced before detection with screening intervals that are longer than three years, but screening more frequently than every three years does not appear to be more beneficial," said Dr. Choi. "The exception is if you have a family member with gastric cancer. In that case, you may need to undergo upper endoscopy screening more frequently than every three years," he added. Patients with a family history of gastric cancer were more likely to have a higher stage at diagnosis if they had a three-year interval rather than a one-year interval.