Early screening process for gastric cancer

Currently, there is no simple and effective diagnostic method for screening gastric cancer for the entire population. Diagnostic methods such as endoscopy for gastric cancer screening consume a lot of manpower and material resources, and because it is an invasive examination, many asymptomatic patients with low gastric cancer risk find it difficult to accept. Even developed countries with a high incidence of gastric cancer, such as Japan and South Korea, cannot conduct gastric cancer screening for the entire population. Therefore, screening for people at high risk of gastric cancer is a possible and effective method.

Who should be screened?

The incidence of gastric cancer increases with age, and the incidence is lower in people under 40 years old. Most Asian countries set 40 to 45 years old as the starting age for gastric cancer screening. In areas with a high incidence of gastric cancer, such as Japan and South Korea, the screening age is advanced to 40 years old.

The incidence of gastric cancer in people over 40 years old in my country has increased significantly, so it is recommended that 40 years old be the starting age for gastric cancer screening. About half of the patients may have no warning symptoms (gastrointestinal bleeding, vomiting, weight loss, upper abdominal discomfort, upper abdominal mass, etc.), and the proportion of patients under 45 years old with warning symptoms is even lower, so screening subjects should not be excluded due to the absence of warning symptoms. About 10% of gastric cancers show familial clustering, and the incidence of gastric cancer in relatives of gastric cancer patients is 4 times higher than that of those without a family history of gastric cancer.

According to my country's national conditions and gastric cancer epidemiology, people who meet item 1 and any one of items 2 to 6 should be classified as high-risk groups for gastric cancer and are recommended as screening targets:

1) Aged 40 and above, regardless of gender;

2) People in areas with a high incidence of gastric cancer, such as the Northwest (Qinghai, Ningxia, Gansu), Northeast (Liaoning, Jilin, Heilongjiang) and the southeastern coastal areas of Jiangsu, Shanghai, Fujian, Zhejiang, etc.

3) Patients infected with Helicobacter pylori;

4) "Old gastric disease": previous gastric precancerous diseases such as chronic atrophic gastritis, gastric ulcer, gastric polyps, residual stomach after surgery, hypertrophic gastritis, pernicious anemia, etc.

5) Family history: first-degree relatives of gastric cancer patients;

6) Long-term high-salt, pickled food, smoking, heavy drinking and other eating habits