SAN FRANCISCO—Early detection of high-risk, presymptomatic gastric cancer with endoscopic screening is associated with improved patient survival, according to a South Korean study presented at the 2014 Gastrointestinal Cancers Symposium. The authors identified risk factors that can be used to identify candidates for endoscopic screening, including H. pylori seropositivity, family history of gastric cancer, carcinoembryonic antigen, and alcohol consumption.
“Early detection of gastric cancer by screening endoscopy while asymptomatic enhances patient outcomes, especially in high-risk groups,” reported lead study author Hwoon-Yong Jung, MD, PhD, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea, and coauthors.
“A customized screening program for gastric cancer would optimize the benefits of screening endoscopy,” Dr. Jung said.
To determine the survival benefits of screening endoscopy and early detection, and to identify factors that might be used to identify high-risk individuals for screening, the researchers compared endoscopy-screening patients’ outcomes and risk factors with those of age- and sex-matched patients diagnosed at an outpatient clinic between 2000 and 2010.
In a total patient population of 109,530 (327 of whom were diagnosed with gastric cancer), independent risk factors for gastric cancer included H. pylori seropositivity (odds ratio [OR], 2.933; P < 0.001), carcinoembryonic antigen (OR, 8.633; P = 0.004), family history of gastric cancer (OR, 2.254; P = 0.007), and alcohol consumption (OR, 3.312; P < 0.001).
Multivariate analysis identified aspirin use as a protective factor against gastric cancer (OR, 0.445; P = 0.012), Dr. Jung noted.
Independent risk factors for mortality in this population included low density lipoprotein cholesterol, cancer antigen 19-9, resectability, and family history of gastric cancer.
The 2014 Gastrointestinal Cancers Symposium is sponsored by the American Gastroenterological Association (AGA) Institute, the American Society of Clinical Oncology (ASCO), the American Society for Radiation Oncology (ASTRO), and the Society of Surgical Oncology (SSO).