Introduction Gastric is the fifth most common cancer and second most common cause of cancer-related death worldwide. The aim of this review is to evaluate the effect of gastric cancer screening upon stage at diagnosis and survival from disease.
Method A systematic review of the literature between January 1995 and December 2014 was performed. All studies that compared screened vs. non-screened populations for the diagnosis of gastric cancer and included an outcome of stage at diagnosis were analysed. The QUADAS-2 tool was used to assess the quality of the studies.
Results 11 studies comprising 4039 in the screened and 6635 in non-screened groups were included. Screening was associated with a significant increase in the detection of early gastric cancer (POR = 3.90; 95% C. I. 3.01 to 5.06; P < 0.0001) and reduction in the incidence of advanced gastric cancer (POR = 0.27; 95% C. I. 0.20 to 0.35; P < 0.0001). Furthermore screening significantly improved 5-year survival (POR = 0.56; 95% C. I. 0.48 to 0.66; P < 0.0001). The overall diagnostic accuracy for barium radiography was good as illustrated by summary ROC analysis with an area under the curve of 0.95 ± 0.01. QUADAS-2 assessment highlighted potential biases within the reference standards.
Conclusion Screening for gastric cancer is useful in detecting asymptomatic patients with early gastric cancer in high prevalence areas. This in turn, increases the number of treatable cancers and improves five-year survival. There is a need for the development and validation of alternative risk-stratification tools in low incidence areas to allow for similar benefits.
Disclosure of interest None Declared.
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