Does the interval of screening endoscopy affect survival in gastric cancer patients?

Abstract

Gastric cancer remains the second most common cancer in Korea; however, its mortality has decreased due to earlier diagnosis. In Korea, screening endoscopy has been performed nationwide since 1999. The aim of this study was to elucidate the benefit of screening endoscopy on actual survival in gastric cancer patients and to determine the optimal interval of screening endoscopy.We analyzed 1651 patients diagnosed with gastric adenocarcinoma who underwent surgical treatment between June 2008 and December 2014. Patients were divided into 4 groups according to the interval of screening endoscopy prior to their gastric cancer diagnosis. (Group I = within 1 year, Group II = >1 but <2 years, Group III = more than 2 years, Group IV = no prior endoscopic examination). Patient demographics, clinicopathologic characteristics, and postoperative surgical outcomes including overall survival were compared.The 5-year gastric cancer-specific survival rates of groups I and II were significantly higher than groups III and IV (90.9% vs 85.4%, P = 0.002, respectively). Multivariate analysis showed that screening interval was an independent factor for the diagnosis of advanced gastric cancer. The risk of advanced gastric cancer decreased in group I (odds ratio: 0.515, 95% confidence interval [CI] 0.369–0.719; P < 0.001) and group II (odds ratio: 0.678, 95% CI 0.517–0.889, P = 0.005).Screening endoscopy was helpful in increasing the survival of gastric cancer patients. A 2-year endoscopic screening interval is suitable to detect early-stage gastric cancer.

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

“…As a result, the 5-year GC-specific survival rates of < 2 years interval group were significantly higher than > 2 years interval group and the risk of AGC decreased in < 2 years interval group. 24 In addition, a 1-year GC screening interval is beneficial for patients with severe intestinal metaplasia in another study. 5 As mentioned above, our study showed that both endoscopic intervals of < 2 years and 3 years are appropriate for EGC detection.…”

“… 22 23 Other studies have suggested that biennial endoscopic screening can increase the rate of early detection of EGC and reduce the number of cases of progression to AGC. 10 24 In one cross-sectional study of these reports, the authors analyzed GC patients except the group of endoscopic resection as a treatment of GC. As a result, the 5-year GC-specific survival rates of < 2 years interval group were significantly higher than > 2 years interval group and the risk of AGC decreased in < 2 years interval group.…”

Optimal interval of endoscopic screening based on stage distributions of detected gastric cancers

“…Previous studies conducted in Korea have concluded that the interval of endoscopic screening could be expanded to 2–3 years based on the stage distributions of the detected cancers and the previous endoscopic examinations [ 19 – 21 ]. In a nested case-control study conducted under a Korean national program, reduction in gastric cancer mortality could be confirmed even if the patients were screened only once within 4 years or more after the diagnosis of gastric cancer for case groups [ 16 ].…”

Gastric Xanthoma Is Related to the Rapid Growth of Gastric Cancer

“…Patients were excluded if they satisfied any of the following exclusion criteria: remnant stomach, familial adenomatous polyposis (FAP), or lack of data years before detection (including cases without identified lesion location in the initial EGD). Included cases were classified as a slow-growth group, comprising patients whose findings showed cancer in previous endoscopic images ( Figure 1 ), or a rapid-growth group, comprising cases whose findings showed no cancer in previous endoscopic images ( Figure 1 ) [ 6 , 13 , 14 ]. The study protocol was approved by the ethics committee/institutional review board at Hyogo College of Medicine, Japan (approval no.…”