Clinical Review
Clarifying the Links Between Gallbladder Disease and Cancer
This study documented patients with cholecystitis to determine cancer risk over a follow-up period of a median 5.4 years.
Endoscopies do not necessarily help catch early gastric cancer in young people, say researchers from Severance Hospital, Seoul, and Hanyang University, Guri, both in Korea.
In countries such as Korea and Japan, where the researchers say Helicobacter pylori is endemic and gastric cancer is prevalent, screening for gastric cancer is recommended for people aged ≥ 40 years. In a previous study, they found that biennial endoscopies increased the diagnosis of gastric neoplasms, including gastric cancer and adenoma, at an early stage in people aged ≥ 40 years. Noting that disease-free status and overall survival of younger patients with gastric cancer are dependent on the cancer’s stage at diagnosis, as is the case with middle-aged patients, they wanted to find out whether earlier periodic endoscopies would be useful.
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In their study, 101 patients underwent screening endoscopy within 24 months after receiving their gastric cancer diagnosis. Another 463 had not had an endoscopy within 2 years. Overall, 65% to 68% had early gastric cancer, but the researchers found no significant difference between the 2 groups. However, the proportion of lesions that were treated with endoscopic submucosal dissection (ESD) differed according to the interval: 9.8% for ≤ 24 and 4.5% for ≥ 24 months.
The only factor associated with early gastric cancer was gastrointestinal symptoms at the time of diagnosis.
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Performing an earlier endoscopy detected gastric cancer at a smaller size (23.8 mm in the ≤ 24-month group vs 30.5 mm in the ≥ 24-month group), which could facilitate treatment with ESD, the researchers say. They suggest that although not necessarily influencing early diagnosis, periodic endoscopies may help increase the proportion of lesions treated with ESD.
Source:
Park CH, Kim EH, Chung H, et al. PLoS One. 2016;11(7):e0159759.
doi: 10.1371/journal.pone.0159759.