Optimal Endoscopic Screening Interval for Early Detection of Gastric Cancer: a Single-Center Study

Abstract

BackgroundThe optimal endoscopic screening interval for early gastric cancer (EGC) detection still remains controversial. Thus, we performed this prospective study to clarify the optimal interval between endoscopic examinations for EGC detection.MethodsA questionnaire survey for penultimate endoscopy and gastric cancer (GC) diagnosis interval was used; the findings were then analyzed. The patients were divided into two groups according to GC type and endoscopic examinations intervals.ResultsA total of 843 patients were enrolled. The endoscopic GC detection interval (P < 0.001), tumor location (P < 0.001), tumor size (P < 0.001), histology (P < 0.001), tumor stage (P < 0.001), and treatment modality (P < 0.001) showed significant differences in the univariate analysis between EGC and advanced gastric cancer (AGC). Endoscopic examination intervals below 2 years and 3 years were associated with higher proportions of EGC detection (adjusted odds ratio, 2.458 and 3.022, respectively) (P < 0.001). The patients with endoscopic examination to GC diagnosis interval of < 2 years showed significant differences in tumor size (P < 0.001), tumor stage (P < 0.001), and treatment modality (P < 0.001) compared to those with intervals of > 2 years and without screening. Similar results were observed in those with < 3-year intervals.ConclusionTriennial endoscopic screening might be as effective as biennial screening in increasing the detection rate of EGC and the risk of subsequent curable endoscopic resections.

The More, the Better: Is This True in Endoscopy for Gastric Cancer Screening?

“…There was a significant dose-response relationship between surveillance interval and the rate of curative endoscopic resection. These results are similar to that of another Korean study published recently, which showed that triennial endoscopic screening might be as effective as biennial screening in detection of early gastric cancer and subsequent curative endoscopic resection rate [ 4 ]. Another study raised the issue of patients with a high risk of gastric cancer, such as those with intestinal metaplasia, and insisted that screening at 1-year interval would be beneficial in such cases [ 5 ].…”

Improving Efficacy of Endoscopic Diagnosis of Early Gastric Cancer: Gaps to Overcome from the Real-World Practice in Vietnam

“…Currently, there is no national screening program for GC in Vietnam, and some hospitals designed their own surveillance schedules. Recent studies reported that a surveillance interval of every two years would be ideal to detect GC in the early stages [14,15], but the crucial issue would be the quality of the index EGD endoscopic examination as well as the endoscopist's experience in recognizing [16]. This is an important issue which should be further investigated in future studies.…”

Deconvolution of diffuse gastric cancer and the suppression of CD34 on the BALB/c nude mice model

“…Heterotopic xenograft mice model 1 × 10 7 GCCs were transplanted into the proximal thigh region of BALB/c nude mice (male), and we observed the model until the tumor volume expanded up to 4000 mm 3 . Implanted tumor size was assessed three times per week and calculated by (4/3) × π × (minor axis/ 2) 2 × (major axis/2) mm 3 . Tumorigenicity was measured in the third week after injecting the cells (n = 10 per group).…”

“…And the incidence of GCA is profound in South Korea, Mongolia, China, and Japan [1]. Even though early detection of the tumor can prolong the survival of patients [2,3], about 33% of patients with gastric cancer (GCA) are diagnosed with diffuse GCA (DGCA) [4]. As the name implies, DGCA infiltrates the contour of the stomach insidiously, which lead to the incomplete resections.…”