Stomach Cancer Early Detection, Diagnosis, and Staging

In the United States, no major medical organizations recommend routine screening for stomach cancer in people who aren’t at increased risk. This is largely because this disease isn’t common in the US, so the benefits of screening most likely would not outweigh the possible risks (such as needing further tests or procedures, even in some people who might not end up having stomach cancer).

Because routine screening for stomach cancer isn’t done in the US, most people aren’t diagnosed until they have certain signs and symptoms that point to the need for medical tests.

In some countries in East Asia, where stomach cancer is much more common, mass screening of the population has helped find many stomach cancers at an early, possibly more curable stage.

The benefits of screening might outweigh the risks in people with certain risk factors for stomach cancer, such as:

• People with potentially precancerous stomach conditions, stomach polyps, or pernicious anemia
• People with inherited cancer syndromes that increase their risk, such as Lynch syndrome or familial adenomatous polyposis (FAP)
• People with close family members who’ve had stomach cancer
• People who’ve had stomach surgery
• First-generation immigrants from countries where stomach cancer risk is higher

Some doctors might recommend tests such as upper endoscopy at regular intervals in these people.

If you have risk factors that might increase your risk of stomach cancer, talk to your doctor about the possible pros and cons of stomach cancer screening for you.

Diffuse gastric and lobular breast carcinoma syndrome (DGLBCS)

People with this syndrome, formerly known as hereditary diffuse gastric cancer (HDGC), have a greatly increased risk of stomach cancer, which often develops at an early age.

Regular screening with thorough upper endoscopies might be an option for some people known to have a CDH1 or CTNNA1 gene mutation that causes DGLBCS, especially if a person has no family history of stomach cancer. However, doctors often recommend that people who have this syndrome consider having their stomach removed (a total gastrectomy), because their risk of stomach cancer is high.

It’s important to discuss your options thoroughly with your health care team, as each can have pros and cons. Surgery is more likely to be recommended if you meet certain criteria, such as having a family history of stomach cancer, symptoms that might be from stomach cancer, or some types of abnormal findings on an upper endoscopy.