Identifying high-risk individuals for gastric cancer surveillance from western and eastern perspectives: Lessons to learn and possibility to develop an integrated approach for daily practice

Figure 1 The estimated age-standardized incidence rate for gastric cancer in 2018 (both sexes, all ages)[1].

Figure 2 Possibly cost-effective approaches for identifying asymptomatic individuals with a high risk of gastric cancer development. ¹The age-standardized incidence rate is greater than 20 per 100000. ²Applying selective screening for subjects with high-risk pre-endoscopic features. ³Not yet shown to reduce gastric cancer mortality. ⁴The performance of serum PG I/II ratio should be locally validated. ⁵Cost-effectiveness should be considered based on the local age-standardized incidence and the cost of esophagogastroduodenoscopy. In multi-ethnic populations, ethnicity-based screening for high-risk ethnic groups should be considered. EGD: Esophagogastroduodenoscopy; UGS: Upper gastrointestinal series; sPGr: Serum PG I/II ratio.

Figure 3 The age-standardized incidence and mortality rates of gastric cancer[1]. ASR: Age-standardized rate[1].

Figure 4 Resource-sensitive approaches to identifying high-risk patients who undergo esophagogastroduodenoscopy for any reason. WLE: White-light endoscopy; EGA: Endoscopic gastric atrophy; GC: Gastric cancer; IEE: Image-enhanced endoscopy.