Gastric Cancer Screening Strategies and Outcomes
Summary
Gastric cancer remains a major global health burden, particularly in East Asia where incidence and mortality rates are highest. Screening strategies have evolved from radiographic methods to direct endoscopic examination, enabling early detection of premalignant lesions and early-stage disease. Organised programmes in countries such as South Korea and Japan have demonstrated reductions in mortality, using repeated endoscopic screening at population scale. More recently, risk stratification models have incorporated demographic, lifestyle and serological biomarkers to refine screening eligibility and interval. Microsimulation and health economic modelling have informed national guidelines by evaluating the cost-effectiveness of varying ages, intervals and modalities. Outcomes are assessed in terms of detection rate, mortality reduction, quality-adjusted life-years and cost per life-year gained. Despite clear benefits, challenges remain in resource allocation, access to skilled endoscopists, standardisation of protocols and integration of emerging non-invasive biomarkers. Future directions include personalised screening based on validated risk scores, integration of molecular markers with traditional endoscopic surveillance and expansion of programmes to regions with rising disease burden.
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Gastric Cancer Screening Strategies and Outcomes publication trend
The graph below shows the total number of articles in gastric cancer screening strategies and outcomes across all publications each year (not limited to Nature Index journals).
Technical terms
Endoscopic screening: Direct visual examination of the gastric mucosa using a flexible endoscope to detect early neoplastic lesions.
Synthetic control method: A statistical technique that constructs a weighted combination of unexposed populations to estimate the counterfactual outcome in an intervention region.
Risk stratification: The process of categorising individuals into distinct risk tiers to tailor screening intensity and frequency.
Quality-adjusted life-year (QALY): A measure combining life expectancy with quality of life on a scale where one QALY equals one year in perfect health.
Incremental cost-effectiveness ratio (ICER): The additional cost per additional health benefit (often per QALY gained) when comparing two screening strategies.
References
- The Effect of Nationwide Organized Cancer Screening Programs on Gastric Cancer Mortality: A Synthetic Control Study. Gastroenterology (2023).
- Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations. BMC Medicine (2023).
- Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study. BMC Medicine (2020).
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