Periodic Endoscopies Might Not Increase the Detection of Early Gastric Cancer in a Young Population

Abstract

Background Screening endoscopies in individuals 40 years or older in regions where gastric cancer is prevalent increase the diagnosis of gastric cancer at an early stage. However, the benefits of screening endoscopies in a young population (<40 years) have not been evaluated.

Methods We reviewed data from patients less than 40 years old who underwent endoscopic submucosal dissection or surgery for initial-onset gastric cancer. We also administered a questionnaire to gather information concerning periodic endoscopic inspections and the period from the penultimate endoscopy to diagnosis.

Results Of the 564 patients in this study, 101 (17.9%) patients underwent screening endoscopy within 24 months of their gastric cancer diagnosis. Lesion size was significantly smaller in the ≤24 months group than in the >24 month group (23.8 mm [standard deviation, 22.2 mm] vs. 30.5 mm [standard deviation, 23.1 mm], P = 0.008). However, the proportion of patients with early gastric cancer did not differ between the two groups (≤24 months vs. >24 months group; 67.6% vs. 65.7%, P = 0.712). On multivariable analysis, periodic endoscopies did not influence the early diagnosis of gastric cancer (with >24 months as the reference group: ≤24 months, odds ratio = 0.939, 95% confidence interval = 0.583–1.513).

Conclusion Although periodic endoscopies aided in the detection of gastric cancer when lesions were smaller in size, they seemed not to increase the proportion of patients with early gastric cancer in young patients diagnosed with resectable gastric cancer.