Screening for gastric cancer in Asia: current evidence and practice.
Gastric cancer is the second most common cause of death from cancer in Asia. Although surgery is the standard treatment for this disease, early detection and treatment is the only way to reduce mortality. This Review summarises the epidemiology of gastric cancer, and the evidence for, and current practices of, screening in Asia. Few Asian countries have implemented a national screening programme for gastric cancer; most have adopted opportunistic screening of high-risk individuals only. Although screening by endoscopy seems to be the most accurate method for detection of gastric cancer, the availability of endoscopic instruments and expertise for mass screening remains questionable--even in developed countries such as Japan. Therefore, barium studies or serum-pepsinogen testing are sometimes used as the initial screening tool in some countries, and patients with abnormal results are screened by endoscopy. Despite the strong link between infection with Helicobacter pylori and gastric cancer, more data are needed to define the role of its eradication in the prevention of gastric cancer in Asia. At present, there is a paucity of quality data from Asia to lend support for screening for gastric cancer.
Leung
Wai K
WK
Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China. dr_wkleung@alumni.cuhk.net
Wu
Ming-shiang
MS
Kakugawa
Yasuo
Y
Kim
Jae J
JJ
Yeoh
Khay-guan
KG
Goh
Khean Lee
KL
Wu
Kai-chun
KC
Wu
Deng-chyang
DC
Sollano
Jose
J
Kachintorn
Udom
U
Gotoda
Takuji
T
Lin
Jaw-town
JT
You
Wei-cheng
WC
Ng
Enders K W
EK
Sung
Joseph J Y
JJ
D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D005260:Female; D005755:Gastrins / Q000097:blood; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality
D005755:Gastrins; C013550:gastrin 17