Gastric Cancer Endoscopic Screening in an Intermediate-Risk Country—A Dual-Center Pilot Program

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2025-08-05 DOI:10.1111/hel.70061

M. B. Mourato, N. Pratas, A. Branco Pereira, F. Costa Pinto, R. Dinis, I. Fronteira, M. Areia

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引用次数: 0

Abstract

Background

Gastric cancer remains a major global health concern and is still frequently diagnosed at advanced stages in Western countries. Despite increasing evidence supporting the role of endoscopic screening in intermediate-risk regions such as Portugal, no national program currently exists. This study aimed to evaluate the feasibility, adherence, and diagnostic yield of opportunistic upper endoscopy performed simultaneously with colorectal cancer screening.

Material and Methods

We conducted an observational retrospective study including individuals aged 50–74 years scheduled for a screening colonoscopy, who were invited to undergo an additional upper gastrointestinal endoscopy, between February 2023 and February 2025 in two endoscopy units in the Alentejo region of Portugal. Data regarding demographics, endoscopic findings, and histology were collected and analyzed descriptively.

Results

Of 401 individuals invited, 380 (94.8%) accepted and underwent upper endoscopy, and 377 were included in the final analysis. Histological findings included Helicobacter pylori infection (30.8%), chronic atrophic gastritis (36.9%) and intestinal metaplasia (10.1%). Regarding neoplastic lesions, 2 cases (0.5%) of low-grade intraepithelial neoplasia, 3 cases (0.8%) of gastric adenocarcinoma, and 2 cases (0.5%) of gastrointestinal stromal tumors were identified, yielding a total malignancy rate of 1.9%; no early gastric cancers were identified. Colorectal findings included 29.2% precancerous lesions and 3.4% invasive colorectal cancer.

Conclusion

This study confirms that opportunistic upper endoscopic screening, integrated into colorectal cancer-screening programs, is feasible, well accepted, and diagnostically valuable in an intermediate-risk Western population. The high rate of precancerous conditions and malignant lesions detected reinforces the need for structured screening strategies. These results align with international recommendations and provide real-world evidence to support broader implementation in similar healthcare contexts.

Study Registration

ClinicalTrials.gov: NCT06316882

查看原文本刊更多论文

中等风险国家的胃癌内镜筛查——双中心试点项目

胃癌仍然是一个主要的全球健康问题，在西方国家仍然经常在晚期被诊断出来。尽管越来越多的证据支持内窥镜筛查在葡萄牙等中等风险地区的作用，但目前尚无国家规划。本研究旨在评估机会性上消化道内镜与结直肠癌筛查同时进行的可行性、依从性和诊断率。材料和方法我们进行了一项观察性回顾性研究，纳入了50-74岁计划进行筛查性结肠镜检查的个体，他们被邀请在2023年2月至2025年2月期间在葡萄牙阿连特约地区的两个内窥镜检查单位接受额外的上消化道内窥镜检查。收集了人口统计学、内窥镜检查和组织学方面的数据，并对其进行了描述性分析。结果被邀请的401人中，380人（94.8%）被接受并接受了上肢内窥镜检查，377人最终入选。组织学表现为幽门螺杆菌感染（30.8%）、慢性萎缩性胃炎（36.9%）、肠化生（10.1%）。在肿瘤病变方面，发现低级别上皮内瘤变2例（0.5%），胃腺癌3例（0.8%），胃肠道间质瘤2例（0.5%），总恶性率1.9%；未发现早期胃癌。结直肠检查结果包括29.2%的癌前病变和3.4%的浸润性结直肠癌。结论：本研究证实，将机会性上消化道内镜筛查纳入结直肠癌筛查方案，在西方中等风险人群中是可行的、被广泛接受的，并且具有诊断价值。癌前病变和恶性病变的高检出率加强了对结构化筛查策略的需求。这些结果与国际建议一致，并为支持在类似卫生保健环境中更广泛地实施提供了现实证据。临床试验网站：NCT06316882

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.