Endoscopy 

Endoscopy is indicated for stomach (gastric) cancer screening primarily in high-risk populations and in individuals with specific risk factors or precursor lesions.

Key indications for endoscopic screening for gastric cancer include:

  • Individuals in high-incidence countries (e.g., Japan, South Korea, parts of China), where population-based endoscopic screening programs are implemented due to proven mortality reduction[2][4].
  • Individuals with a family history of gastric cancer, especially first-degree relatives[2].
  • Patients with precancerous gastric lesions, such as gastric intestinal metaplasia or chronic atrophic gastritis, who are considered at increased risk and may benefit from surveillance endoscopy[1][2].
  • Patients with pernicious anemia are at increased risk of gastric cancer and warrant endoscopic surveillance[1].
  • Individuals with a history of partial gastrectomy for benign disease, due to increased risk of cancer in the gastric remnant[1].
  • Patients with certain hereditary cancer syndromes (e.g., hereditary diffuse gastric cancer, Lynch syndrome) as per guideline recommendations[2].

In low- and intermediate-incidence countries, routine population-based endoscopic screening is not generally recommended; instead, a risk-stratified approach is favored, focusing on surveillance of high-risk subgroups (e.g., those with extensive intestinal metaplasia or strong family history)[2].

Indication for Endoscopy 

  • Population-based screening
  • Family history
  • Precancerous lesions
  • Pernicious anemia
  • Post-gastrectomy
  • Hereditary

Population/Condition 

  • High-incidence countries (e.g., Japan, South Korea)
  • First-degree relatives of gastric
  • Gastric intestinal metaplasia, chronic atrophic gastritis
  • Diagnosed patients
  • Patients with prior partial gastrectomy
  • CDH1 mutation, Lynch syndrome, etc.

Rationale 

  • Proven mortality reduction, early detection[2][4]
  • Increased risk[2]
  • Higher risk of progression to cancer[1][2]
  • Increased risk of gastric
  • Risk of cancer in gastric
  • Guideline-based surveillance[2]

Sources:

  1. Endoscopy in screening for digestive cancer.
  2. Endoscopic screening and surveillance for gastric cancer: challenges and opportunities.
  3. Value of screening endoscopy in evaluation of esophageal, gastric and colon cancers.
  4. Screening for Gastric Cancer: The Usefulness of Endoscopy.
  5. Quality indicators in the endoscopic detection of gastric ….