How long should we continue gastric cancer screening? From an epidemiological point of view

Mizota, Yuri; Yamamoto, Seiichiro

doi:10.1007/s10120-018-0877-z

Cited by 15 publications

(11 citation statements)

References 11 publications

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“…Population-based cancer screening should be safe and effective; in addition, favorable cost-effectiveness and reasonable work burden are essential [22,23]. In this sense, the necessity and method of gastric cancer screening should always be discussed according to the prevalence of gastric cancer and the situation of risk factors such as H. pylori in the future [24]. The time is presumably approaching when a more risk-stratified screening approach with consideration of the status of risk factors, particularly the status of H. pylori, should be considered.…”

Section: Gastric Cancer Screeningmentioning

confidence: 99%

Epidemiological Trends and Future Perspectives of Gastric Cancer in Eastern Asia

et al. 2021

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Background: The global epidemiological situation of gastric cancer has changed considerably over time, and it is essential to understand the epidemiological trends and future perspectives of gastric cancer. Summary: Although gastric cancer was common in the United States less than a century previously, it is no longer common in this country. Currently, over 60% of gastric cancers are found in Eastern Asia. In some Eastern Asian countries such as Japan and Korea, population-based gastric cancer screening has been conducted using upper gastrointestinal endoscopy or radiography to lower gastric cancer mortality. Due to earlier detection of gastric cancer, the survival of patients with gastric cancer is more favorable in these countries than in other Western countries. Even in Eastern Asia, a remarkable decrease in the age-standardized incidence and mortality of gastric cancer has been observed. This downward trend is mainly due to the reduced Helicobacter pylori infection, and this trend is considered to continue. Nevertheless, both the absolute number of incident cases and deaths of gastric cancer are still increasing at present due to the aging population. For the time being, the management of gastric cancer in elderly population is a critical issue in Eastern Asia. The absolute numbers of gastric cancer cases and deaths are believed to peak in the near future, following the decreasing age-standardized incidence and mortality. Key Messages: After a long period, gastric cancer may become a rare cancer even in Eastern Asia, and new efficient approaches for its prevention, screening, and treatment are warranted.

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Section: Gastric Cancer Screeningmentioning

confidence: 99%

Epidemiological Trends and Future Perspectives of Gastric Cancer in Eastern Asia

et al. 2021

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“…Since H. pylori prevalence rates are markedly lower in younger people compared to that in older people, 6 the prevalence of gastric cancer will decrease but patients with gastric cancer will be older. 80 In elderly patients with gastric cancer, it is necessary to evaluate not only the risk for LNM but also the condition of the patients because heterogeneity in the aging process leads to a diverse range of age-related declines in health and physical status among elderly patients. To date, several indices for evaluating the condition of patients, such as prognostic nutritional index, 81,82 Charlson comorbidity index, 81,83 and American Society of Anesthesiologists' Physical Status, 84,85 have been reported as indicators for the prognosis in patients with EGCs.…”

Section: Management After Noncurative Resectionmentioning

confidence: 99%

A Recent Argument for the Use of Endoscopic Submucosal Dissection for Early Gastric Cancers

et al. 2020

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Endoscopic submucosal dissection (ESD) has become the standard treatment method for early gastric cancers (EGCs) due to the negligible risk for lymph node metastasis (LNM) in Eastern Asian countries. According to the guidelines, the curability of EGC after endoscopic resection was classified into three groups: curative resection, expanded curative resection, and noncurative resection. In Eastern Asian countries, a structured follow-up schedule is needed for patients undergoing curative resection and expanded curative resection. Conversely, in Western countries, additional surgery may be recommended for some patients undergoing expanded curative resection (ulcerated, undifferentiated, or slight submucosal invasion) due to the potential risk for LNM, even though specimens of ESD and surgery may not be handled with the same methodology as that used in Japan, which may lead to this slightly higher risk. In noncurative resection, additional surgery is the standard method after ESD because of the risk for LNM. However, in elderly patients and/or those with severe underlying diseases, the advantages and disadvantages of additional surgery should be considered when selecting a post-ESD treatment strategy for patients undergoing noncurative resection. Risk-scoring systems for LNM may facilitate clinical decisions for these patients. However, it should be noted that when recurrence was detected in patients who were followed up with no additional treatment after ESD with noncurative resection, most of them had a poor prognosis. To select an appropriate treatment method, especially in elderly patients undergoing ESD with noncurative resection, a new tool for evaluating the condition of patients should be established. (Gut Liver 2020;14:412-422 ) This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…[30][31][32][33][34][35] With the ongoing growth of the aged population, the rate of elderly patients among the total population with upper GI neoplasia in Japan has also been rising. 36,37 Elderly patients have unique age-related variations in their physical condition that contribute to increased complexity in treatment decision-making. 38 Recently, guidelines for the treatment of elderly patients with diabetes mellitus were published.…”

Section: Introductionmentioning

confidence: 99%

Management following endoscopic resection in elderly patients with early‐stage upper gastrointestinal neoplasia

Hatta

Gotoda

Koike

et al. 2020

Digestive Endoscopy

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With the ongoing increase in the aging population in Japan, the number of elderly patients among the total population with upper gastrointestinal (GI) neoplasia has also been increasing. As elderly patients present unique age‐related variations in their physical condition, the therapeutic approach for upper GI neoplasia should be differentiated between elderly and nonelderly patients. According to the existing guidelines, additional treatment is the standard therapy in patients who undergo endoscopic resection (ER) with a possible risk of lymph node metastasis (LNM) for upper GI neoplasia. However, due to the relatively low rate of LNM, applying additional treatment in all elderly patients may be excessive. Although additional treatment has the advantage of reducing cancer‐specific mortality, its disadvantages include deteriorated quality of life, complications, and mortality in surgery. In patients with early gastric cancer, we propose treatment decisions be made using a risk‐scoring system for LNM and upon considering the physical condition of the patient after ER with curability C‐2. In those with superficial esophageal squamous cell carcinoma with a possible risk of LNM after ER, selective chemoradiotherapy may be a less‐invasive treatment option, although the present standard treatment is esophagectomy. When considering the treatment decision, achieving a “cure” of the tumor has been regarded as critical. However, as the main cause of mortality in elderly patients with ER for upper GI neoplasia is noncancer‐related death, both achieving a “cure” and also a good level of “care” is important in the management of elderly patients.

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How long should we continue gastric cancer screening? From an epidemiological point of view

Cited by 15 publications

References 11 publications

Epidemiological Trends and Future Perspectives of Gastric Cancer in Eastern Asia

Epidemiological Trends and Future Perspectives of Gastric Cancer in Eastern Asia

A Recent Argument for the Use of Endoscopic Submucosal Dissection for Early Gastric Cancers

Management following endoscopic resection in elderly patients with early‐stage upper gastrointestinal neoplasia

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