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Endoscopic Gastric Cancer Screening and Surveillance in High-Risk Groups

机译：高危人群的内镜胃癌筛查和监测

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摘要

Gastric cancer remains a major cancer problem world-wide and future incidence will likely increase due to rapidly aging population demographics. Population-based screening is being undertaken in Korea and Japan, where gastric cancer incidence rates are high, and seems to be effective in reducing mortality from gastric cancer. However, such strategies are difficult to implement in countries with a low incidence or limited resources. Thus, screening strategies should be directed towards high-risk population subgroups. Gastric cancer has a relatively long mean sojourn time, and prognosis of early-stage disease is excellent. In general population, screening at 2-year interval in Korea seems to be effective for early-stage diagnosis. In subjects with atrophic gastritis or intestinal metaplasia, surveillance is recommended at 1 to 3 years intervals according to European and Japanese recommendation. Screening intervals for family members with sporadic gastric cancer has not yet been adequately evaluated, but 1-year interval is recommended for hereditary diffuse gastric cancer family-members. Gastric cancer patients treated by endoscopic resection are the highest-risk group, and 1-year interval surveillance can detect most metachronous gastric cancers at an early stage. Future gastric cancer surveillance strategies using endoscopy should be guided by risk-stratification assessment, and further refinement of optimal surveillance intervals is needed.
机译：胃癌仍然是世界范围内的主要癌症问题，由于人口老龄化迅速，未来的发病率可能会增加。在韩国和日本，正在进行基于人群的筛查，这些国家的胃癌发病率很高，并且似乎可以有效降低胃癌的死亡率。但是，在发病率低或资源有限的国家很难实施这种战略。因此，筛查策略应针对高危人群。胃癌的平均住院时间相对较长，早期疾病的预后极好。在一般人群中，韩国每隔2年进行一次筛查似乎对早期诊断是有效的。对于萎缩性胃炎或肠上皮化生的患者，建议根据欧洲和日本的建议每隔1至3年进行一次监测。散发性胃癌家庭成员的筛查间隔尚未得到充分评估，但遗传性弥漫性胃癌家庭成员建议间隔为一年。内镜下切除术治疗的胃癌患者是最高风险组，并且一年间隔监测可以在早期发现大多数异时性胃癌。未来使用胃镜检查的胃癌监测策略应以风险分层评估为指导，并且需要进一步优化最佳监测间隔。

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