The researchers conducted a study to identify patients at high risk of gastric cancer, who should be examined by repeat endoscopy within a short time after obtaining initial negative results.
They reported their findings in the April issue of Endoscopy.
3,672 patients who were not diagnosed as having gastric cancer by endoscopy in 1993 were enrolled in the study. All underwent re-examination by gastroscopy between January 1994 and December 1996.
Among these participants, 32 patients (1%) were diagnosed as having gastric cancer.
|Gastric cancer rates after repeat endoscopy:|
Patients in their sixties:
Patients with atrophy of gastric mucosa:
The incidence of gastric cancer was 2% in participants aged 60 to 69, and 3% in those with marked atrophy of the gastric mucosa. Multivariate analysis showed that the odds ratios (OR) were 3.1 and 3.3, respectively.
Gastric cancer was detected in 17% of patients who were previously diagnosed as having gastric adenoma, and in 2% of those who were previously diagnosed as having gastric ulcer. The ORs for participants with these gastric lesions detected by the initial examination were 49.4 and 5.3, respectively.
Investigator O. Hosokawa, of the Fukui Prefectural Hospital, concluded on behalf of the group, "Groups at high risk for gastric cancer were identified by the initial endoscopy, when two findings (gastric lesions, atrophy) and age were combined.
"We emphasize the importance of repeat endoscopic examination for patients who are aged 60 to 69, or who have marked atrophy of gastric mucosa, even if no lesions are detected on initial endoscopy.
"If gastric adenoma or ulcers are detected, endoscopic examination should be likewise repeated or these lesions should be treated by endoscopy or by other means."