Comparing global trends in gastric cancer and the need for national screening programs: An in-depth literature review

Abstract

Abstract Introduction Gastric cancer, though experiencing a decline in mortality rates, remains a global concern. This study explores the impact of screening strategies and Helicobacter pylori eradication on gastric cancer incidence and mortality, emphasizing global variations in risk factors and screening programs. Methods A literature review was conducted, searching PubMed and Medline databases for relevant studies. Two distinct searches focused on national screening programs and H. pylori eradication effects, yielding 11,378 studies. Selection criteria refined the studies to 37, emphasizing trial data and recent publications. Statistical analysis, including forest plots, was employed to examine screening outcomes and H. pylori eradication therapy. Results Screening demonstrated a 31% decrease in gastric cancer mortality, with varied incidence outcomes. Population control studies showed an insignificant risk reduction (odds ratio [OR] 0.92), while case–control studies indicated an expected increase in cancer incidence (OR 5.15). Screening intervals of 12 months or less correlated with a 30% mortality risk reduction, and repeated screenings further decreased the risk by 79%. H. pylori eradication therapy exhibited a 56% decrease in cancer odds, emphasizing its significance in both asymptomatic and high-risk individuals. Discussion The study underscores the efficacy of screening methods, with endoscopy and Barium X-ray playing pivotal roles in early detection. Optimal screening intervals and the impact of repeated screenings on mortality risk are highlighted. H. pylori eradication emerges as a critical intervention, with a focus on overcoming challenges such as clarithromycin resistance. Successful screening programs in high-risk regions offer insights for global implementation, with research indicating promising avenues for preventive strategies.