Controversies in cancer screening: Gastric Cancer

Gastric cancer is the fifth most common and forth most killer cancer worldwide, and screening remains one of the controversial topics. 75% of all new cases and all deaths from stomach cancer are reported in Asia. Although it is very rare in Northern Europe, Central and Eastern Europe has the second highest prevalence.

Primary and secondary prevention strategies are the focus of stomach cancer prevention. Between 30% and 50% of cancers can be prevented by avoiding well known risk factors and implementing evidence-based prevention strategies, the burden can be reduced through early detection of cancer. A 5-year relative stomach cancer survival rate of about 20% is observed in Western developed countries and in developing countries.

Upper GI endoscopy is the gold standard for stomach cancer diagnosis and used in screening in high-risk areas ( Japan, Korea, Venezuela and etc). But the procedure is quite expensive, unpleasant and has a risk, while the available evidence on endoscopic surveillance of premalignant gastric lesions is showing conflicting results.