How to screen for early gastric cancer? Who needs screening?

Gastric cancer remains a high-incidence cancer worldwide, causing more than 1 million new cases and an estimated 769,000 deaths in 2020, ranking fifth and fourth in global incidence and mortality. The highest incidence rates are found in East Asia (Japan and Mongolia are the countries with the highest incidence rates for men and women, respectively) and Eastern Europe. The 5-year survival rate is 30.4% in the United States and 27.4% in China. Japan is about 78%. There is still a big gap between my country and its neighbor Japan.

Early screening of cancer has a direct impact on prognosis, so how can we scientifically screen for gastric cancer early? First, let's understand the target population for gastric cancer screening - the high-risk population.

High-risk groups for gastric cancer

People aged ≥40 years who meet any of the following criteria are recommended for screening:

1. People living in areas with high incidence of gastric cancer.

2. People infected with Hp (Helicobacter pylori).

3. Patients with a history of gastric precancerous lesions.

4. First-degree relatives of gastric cancer patients.

5. The presence of other high-risk factors for gastric cancer (high salt, pickled diet, smoking, heavy drinking, etc.).

How to screen for early gastric cancer?

The main screening methods for gastric cancer include serological screening and endoscopic screening, and the final diagnosis requires pathological confirmation.

In the past, the combined method of serum PG and Hp antibodies (i.e., the "ABC method") was used to assess the risk of gastric cancer and to screen out people at high risk of gastric cancer.

The results showed that the risk of gastric cancer was classified as follows:

Grade A: PG(-), Hp(-)

Class B: PG(-), Hp(+)

C-level: PG(+), HP(+)

D-level: PG(+), HP(-)

The new gastric cancer screening scoring system includes five variables (age, gender, gastrin 17, Helicobacter pylori antibody, and pepsinogen), with a total score of 0 to 23 points. The target population for gastric cancer screening can be divided into three levels according to the scores:

① High-risk group (17-23 points)

② Moderate-risk group (12-16 points)

③Low-risk group (0-11 points): average risk.

The effectiveness of gastric cancer screening has been significantly improved using the new scoring system.

Scientific early screening of people at high risk of gastric cancer is an effective measure to improve survival rate.