Endoscopic findings in a mass screening program for gastric cancer in a high risk region - Guilan province of Iran.
OBJECTIVE
Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people>50 years targeted in a mass screening program in a hot-point region.


METHODS
Based on the pilot results in Guilan Cancer Registry study(GCRS), one of the high point regions for GC - Lashtenesha - was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation.


RESULTS
Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of 61.7 ± 9.0 years (range:50-87 years) underwent upper GI endoscopy. H.pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one(0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia(38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population.


CONCLUSIONS
Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for GC surveillance program at the national level.
Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran. ghanaie@yahoo.com
Fariborz
F
Mansour-Ghanaei
Homayoon
H
Sokhanvar
Farahnaz
F
Joukar
Afshin
A
Shafaghi
Mahmud
M
Yousefi-Mashhour
Ali Kord
AK
Valeshabad
Saba
S
Fakhrieh
Keyvan
K
Aminian
Kambiz
K
Ghorbani
Zahra
Z
Taherzadeh
Mohammad Reza
MR
Sheykhian
Yaghoub
Y
Rajpout
Alireza
A
Mehrvarz
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D004381:Duodenal Ulcer / Q000175:diagnosis; D016099:Endoscopy, Gastrointestinal; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis; D016480:Helicobacter pylori; D006551:Hernia, Hiatal / Q000175:diagnosis; D006801:Humans; D007492:Iran; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology; D013270:Stomach / Q000201:enzymology / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013276:Stomach Ulcer / Q000175:diagnosis; D014510:Urease / Q000032:analysis
D014510:Urease