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Stomach cancer screening and prevention

Common Early Symptoms (Can mimic other issues)

  • Bloating: Feeling full or swollen in the abdomen, even after eating small amounts. 

  • Stomach Pain: Discomfort or cramps, often above the navel. 

  • Indigestion/Heartburn: A burning feeling or discomfort in the chest or stomach that doesn't go away. 

  • Nausea: Feeling sick to your stomach. 

 

Later-Stage or More Specific Symptoms

  • Vomiting: May include blood, which can look bright red or dark brown (like coffee grounds).

  • Fatigue: Feeling unusually tired or weak.

  • Jaundice: Yellowing of the skin or eyes. 

EGD for stomach Cancer Prevention 

Best Practices for High-Quality Endoscopy (When Screening is Done)

  • High-Definition Endoscopy: Use image enhancement for better visualization. 

  • Mucosal Cleansing: Ensure stomach is clean for optimal view. 

  • Systematic Biopsy: Follow protocols (like the Sydney System) for accurate diagnosis and staging. 

For Average Risk (U.S.)

  • Focus on Symptoms: 

    Diagnosis usually occurs after symptoms appear, prompting tests like upper endoscopy. 

  • No Routine Screening: 

    Major U.S. organizations don't recommend general population screening because benefits don't outweigh harms (like unnecessary procedures). 

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For High-Risk Individuals

  • Who: 

    First-generation immigrants from high-risk areas (Japan, Korea, China, etc.), family history of gastric cancer, certain genetic syndromes (Lynch, FAP), severe atrophic gastritis (GA), or intestinal metaplasia (GIM). 

  • Method: 

    Upper endoscopy (EGD) is the gold standard, allowing visualization and biopsies for staging precancerous conditions. 

  • Key Findings: 

    Look for GA, GIM, or dysplasia. 

  • Surveillance:

    • GA/GIM: Consider surveillance (e.g., every 3 years) for severe atrophy or extensive GIM, especially with other risk factors. 

    • Family History: Consider screening (endoscopy) for first-degree relatives of GC patients. 

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