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World J Gastroenterol. Oct 14, 2014; 20(38): 13767-13774
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.13767
Current issues and future perspectives of gastric cancer screening
Chisato Hamashima
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan
Author contributions: Hamashima C designed and performed review of the recently published research studies, and wrote this article.
Supported by Grant-in-Aid for H22-Third Term Comprehensive Control Research for Cancer 022 from the Japanese Ministry of Health, Labour and Welfare
Correspondence to: Chisato Hamashima, MD, PhD, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan. chamashi@ncc.go.jp
Telephone: +81-3-35475305 Fax: +81-3-35478587
Received: December 9, 2013
Revised: February 14, 2014
Accepted: May 28, 2014
Published online: October 14, 2014
Processing time: 311 Days and 0.4 Hours
Abstract

Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The effectiveness of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and “screen and treat” method were extensively reviewed. Moreover, the phases of development for cancer screening were analyzed on the basis of the biomarker development road map. Several observational studies have reported the effectiveness of endoscopic screening in reducing mortality from gastric cancer. On the other hand, serologic testing has mainly been used for targeting the high-risk group for gastric cancer. To date, the effectiveness of new techniques for gastric cancer screening has remained limited. However, endoscopic screening is presently in the last trial phase of development before their introduction to population-based screening. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be carefully assessed before introducing these new techniques for population-based screening.

Keywords: Gastric cancer screening; Mortality; Upper gastrointestinal endoscopy; Upper gastrointestinal X-ray; Serum pepsinogen test; Helicobacter pylori antibody

Core tip: The effectiveness of new gastric cancer screening technique has remained limited to date. The present review of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and “screen and treat” method provides invaluable insights on how screening tests should be instituted. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be assessed before introducing these new techniques for population-based screening.