Advances in screening and detection of gastric cancer

Abstract

With an estimated one million new cases and 769 000 deaths in 2020, gastric cancer is the fifth most frequent cancer and fourth leading cause of cancer death globally.Incidence rates are highest in Asia and Eastern Europe. This manuscript will review the current modalities of diagnosis, staging, and screening of gastric cancer. We will also highlight development of novel diagnostics and advancements in endoscopic detection of early gastric cancer.

Gastric cancer prevention: Merging future hopes, with present clinical practice

“…In this respect, we would like to offer some comments on the excellent review article "Advances in screening and detection of gastric cancer" by Jonathan Y. Xia and A. Aziz Aadam. 1 We fully agree that "serum tumor markers, including CEA, CA-125, CA 19-9 are of limited diagnostic utility" because of their limited sensitivity and specificity, but we suggest that serum pepsinogen II (PgII) is also an unsuitable marker for the identification of "patients with increased risk." 1 Not only does it, as the authors state, "lacks the sensitivity and specificity to provide any diagnostic value," but it is a marker of inflammation that does not provide any information on either GC risk or current gastric neoplasia.…”

“…1 We fully agree that "serum tumor markers, including CEA, CA-125, CA 19-9 are of limited diagnostic utility" because of their limited sensitivity and specificity, but we suggest that serum pepsinogen II (PgII) is also an unsuitable marker for the identification of "patients with increased risk." 1 Not only does it, as the authors state, "lacks the sensitivity and specificity to provide any diagnostic value," but it is a marker of inflammation that does not provide any information on either GC risk or current gastric neoplasia. 6 In contrast, the PgI/PgII ratio (not mentioned by the authors), while not a marker of existing cancer, may be helpful in detecting subjects with atrophy and, consequently, increased GC risk.…”

“…1,2 GC, a leading cause of cancer-related death worldwide, is at the center of our scientific and clinical activities and we have appreciated the richness of the information on the epidemiology, natural history, diagnostic procedures (including those attempting cancer prevention), and therapeutic innovations provided by the monographic volume of the Journal. 1,2 We have noted, however, with some disappointment, the dearth of information about GC prevention, both primary and secondary. [3][4][5] Surgeons, as the primary audience of the Journal, are not only the leading actors of surgical therapies but they have also been extensively involved in gastrointestinal endoscopy procedures.…”

“…[8][9][10] Both the "future directions" by Xia and Aadam, and the comprehensive review by Shah and Bentrem conclude by presenting a hopeful panorama for tomorrow's gastric cancer prevention. 1,2 However, it is equally important to be alerted about the strategies that can benefit our patients today. [8][9][10]…”

miR-29c inhibits metastasis of gastric cancer cells by targeting VEGFA

“…Gastric cancer (GC) is one of the most common digestive system malignancies associated with high incidence and mortality rate 1 . While great achievements have made major advances in screening, most GC patients were diagnosed with unresectable, locally advanced or metastatic disease and remained to have a poor prognosis 2 , 3 . The metastasis of GC is the main cause of death for patients 4 .…”