Gastroscopy and pathological biopsy are the “gold standard” for the diagnosis of gastric cancer. Some countries in East Asia with a high prevalence of gastric cancer have proposed the use of gastroscopy for gastric cancer screening, but ultimately found that the general population was not well represented and that medical resources were relatively insufficient to screen the entire population for gastric cancer. In China, gastroscopy is also difficult to be used for mass screening due to its invasive nature, high cost and low acceptance by the general population. Therefore, screening for people with high risk of stomach cancer is a proven method for early detection of stomach cancer. So, who are the people who need to be screened?
Screening for gastric cancer usually starts at age 40
Stomach cancer death rates increase with age, are low below age 40, and rise rapidly after age 40. Most Asian countries set the age of 40 to 45 years as the starting age for gastric cancer screening; regions with a high incidence of gastric cancer, such as Japan and Korea, have advanced the starting age to 40 years. In China, the incidence of gastric cancer in people over 40 years of age has increased significantly, so 40 years of age is generally used as the starting age for gastric cancer screening.
Who needs to be screened?
Who needs to be screened for gastric cancer?
Who needs to be screened?
According to the national situation and epidemiological data of gastric cancer in China, and referring to the Expert Consensus Opinion on Early Gastric Cancer Screening Process in China (Draft 2017, Shanghai), the target population for gastric cancer screening in China is defined as those who are not younger than 40 years old and meet any of the following criteria:
- People in areas with high incidence of gastric cancer (e.g. northwest, southeast coastal areas);
- Hp (Helicobacter pylori) infection;
- Previous precancerous diseases of the stomach such as chronic atrophic gastritis, gastric ulcer, gastric polyp, post-surgical residual stomach, hypertrophic gastritis, pernicious anemia;
- First-degree relatives (parents, children, and siblings) of patients with gastric cancer;
- The presence of other risk factors for gastric cancer (e.g. high salt intake, pickled diet, smoking, heavy alcohol consumption, etc.).
Summary
Currently, screening is only available for people at high risk for gastric cancer in China. Because of the significant increase in the incidence of gastric cancer in people over 40 years of age, the age of 40 years is usually used as the starting age for gastric cancer screening. In general, people over the age of 40 with risk factors for gastric cancer need to be screened for gastric cancer.