There is a need for targeted, fast and reliable diagnostics at the point of patient care to identify curable precancerous disease stages that enable timely treatment and better patient outcomes for patients with gastric cancer. Dr. Cinzia Papadia, a Consultant Gastroenterologist at Barts Health NHS Trust and Honorary Senior Lecturer at Queen Mary University of London, discusses the use of a first-line case selection tool for gastric cancer risk.
Gastric cancer is responsible for over 4,000 deaths in the UK every year, and it is estimated that approximately 54 per cent of these cases could have been prevented with earlier detection and prompt intervention.1 In fact, gastric carcinoma is the fourth most common cancer type worldwide and the second highest cause of death compared to all other malignancies.2,3 It is often diagnosed at a late stage, which explains its low 5-year survival rate of between 10 and 30 per cent in Europe.4
Gastric cancer arises from the accumulation of specific genetic changes combined with a mix of environmental influences. This means that there may be opportunities to prevent gastric cancer with strategies such as a healthy diet, therapies targeting H. pylori infection — which is strongly linked to an increased risk — and timely diagnosis through case selection and screening.5—7 Early detection hinges on comprehensive assessments including endoscopic and histological evaluations, alongside the analysis of biomarkers such as pepsinogen I and II and gastrin-17. These biomarkers serve as a non-invasive tool for assessing gastric cancer risk by indicating atrophic gastritis — characterised by reduced stomach acid, malabsorption issues, anaemia and heightened infection risk — which is the most common preneoplastic condition for both intestinal and diffuse type gastric adenocarcinoma.5,8—10
The 2019 guidelines from the British Society of Gastroenterology (BSG)11 promote these preventative strategies, recommending regular screening of at-risk populations and prompt intervention when precancerous conditions are detected. Moreover, the guidelines advocate using histologic tools like the updated Sydney System (USS) and Operative Link for Gastritis Assessment (OLGA) staging system to accurately categorise the severity and cancer risk associated with gastritis. Altogether, identifying relevant biomarkers, testing for H. pylori, and assessing gastritis severity through OLGA staging and endoscopic evaluation, make it possible to detect gastric cancer at an earlier, more treatable stage, thereby improving survival rates.9,12,13
Log in or register FREE to read the rest
This story is Premium Content and is only available to registered users. Please log in at the top of the page to view the full text.
If you don't already have an account, please register with us completely free of charge.
