Gastric Cancer screening – does it exist or not? - literature review

Abstract

INTRODUCTION AND PURPOSE: Gastric cancer (GC) is one of the biggest healthcare problem in the world. Despite the fact that the incidence of this cancer has decreased recently, GC is on the fifth place of causes of morbidity and on the second place of causes of mortality. Therefore, some countries such as Japan and South Korea have decided to establish and develop screening methods to detect GC as early as it is possible and to begin early treatment. DESCRIPTION OT THE STAGE OF KNOWLEDGE: There are many types of screening methods such as: markers of atrophy- serum-pepsinogen test and low serum gastrin-17 concentration, barium photofluorography of mucosa or endoscopy. Upper gastrointestinal endoscopy has the highest detection rate in high-incidence areas, compared to other screening methods, because upper endoscopy makes it possible to highlight changes such as flat and non-ulcerative lesions, which are usually invisible in barium examination. An alternative to screening is the massive eradication of Helicobacter pylori. Occasionally some countries recommend genetic testing and prophylactic gastrectomy. CONCLUSIONS: Despite the high incidence of GC in Asian countries, there is still a lack of data on the cost-effectiveness of mass screening for GC. The main factor influencing the profitability of screening tests for GC is the cost of upper gastrointestinal endoscopy. Moreover, the value and usefulness of the GC screening program remains controversial in many countries.