Detection of an increased incidence of early gastric cancer in patients with intestinal metaplasia type III who are closely followed up

Gastric cancer, a disease associated with significant mortality, is much more successfully treated when detected early than when detected later in the course of its development. In most published studies, 5-year survival rates do not exceed 15 percent. It is thought that frequent screening is particularly important for the early detection of gastric cancer in patient populations who are particularly susceptible to this disease, such as those with abnormalities of gastrointestinal cellular development. To evaluate possible changes in patterns of gastric cancer diagnosis over time and to investigate the utility of frequent screening in high-risk patients, the records of 718 patients who underwent gastrectomy (stomach removal) for gastric cancer between 1976 and 1987 were reviewed. During the second six-year portion of the study, all patients diagnosed with type III intestinal metaplasia (an abnormal condition of the intestinal cells that sometimes presages the onset of gastric cancer) were closely followed up and repeatedly screened for gastric cancer. In 24 of these patients (3.3 percent), gastrectomy was performed in the course of treatment for early (rather than advanced) gastric cancer. Six of the 24 patients were diagnosed in the first six-year period of the study; 18 of the 24 were diagnosed in the second six-year period, indicating that a significantly higher percentage was diagnosed in the more recent period. Eleven of the 18 patients (61 percent) diagnosed with early gastric cancer were diagnosed as a direct result of the increased frequency of screening following the discovery of intestinal metaplasia. Hence, frequent screening for gastric cancer in patients at risk for this condition is an effective method of diagnosing gastric cancer at an early stage. (Consumer Summary produced by Reliance Medical Information, Inc.)