Dyspepsia is common in gastric cancer, but also in many benign conditions.
European Helicobacter pylori Study Group and American Gastroenterological Association guidelines recommend endoscopy in dyspepsia for patients with alarm symptoms or at more than 45 years.
However, recommendations are controversial.
Dr Malfertheiner and colleagues from Germany investigated whether criteria for endoscopy in patients with dyspepsia are adequate to detect gastric cancer.
The research team included 215 patients at initial diagnosis of gastric adenocarcinoma, symptoms and classified them as alarm and non-alarm.
| Only 53 potentially curable stages occurred, but tumour stage was not associated with dyspepsia duration|
|Alimentary Pharmacology and Therapeutics|
The team staged cases were staged according to the TNM system (tumor, lymph nodes and metastasis stages)and stages T1-T3NxM0 were defined as potentially curable.
The investigators observed that dyspepsia was present in 128 patients and among patients with dyspepsia, 15 were 45 years and 41 denied alarm symptoms.
The combination of both criteria excluded only 3 patients from endoscopy, but increasing the threshold to above 50 and 55 years would have raised the rate of excluded patients to 7 and 11.
In addition, the investigative team found that only 53 potentially curable stages and 18 early gastric cancers occurred, but the tumour stage was not associated with dyspepsia duration, age threshold of 45 years, or alarm symptoms.
Dr Malfertheiner concludes, “Our results support current European Helicobacter Study Group and American Gastroenterological Association criteria for endoscopy in patients with dyspepsia to detect gastric cancer.”
“Most cancers are advanced at detection."