Objective To explore the significance of gastric cancer family history and serological indicators combined with 14C-urea breath test in gastric cancer screening among middle-aged and elderly community residents.
Methods We randomly selected 935 residents at ages 40 years and older at 3 communities in Nanking city of Jiangsu province for a survey including questionnaire interview, Helicobacter pylori (HP) detection with 14C-urea breath test (UBT) and blood sample collection for serum tumor marker measurement from May to August 2017. Then, we screened out individuals at a high-risk of gastric cancer based on their family history of gastric cancer and results of HP and serum tumor marker test and carried out a voluntary gastroscopy examination among the residents with a high gastric cancer risk.
Results Among all the participants, totally 102 were assessed with a high risk of gastric cancer. Of the high risk individuals, 10 (9.8%) were seropositive for carcinoembryonic antigen or carbohydrate antigen and 32 (31.4%) were positive for any two of three detection items including strong HP infection, abnormality of blood routine examination, family history of gastric cancer. Various pathologic changes of stomach tissues were observed among all the 20 high-risk individuals having gastroscopy examination voluntarily, including 2 (10.0%) precancerous lesions, 1 (5.0%) neoplasm to be reexamined, 10 (50.0%) chronic atrophic gastritis, and 7 (35.0%) severe superficial gastritis, respectively. The overall detection rate of precancerous lesion for the comprehensive screening was 10%.
Conclusion The comprehensive screening method established in this study has a high detection rate of precancerous lesions, which is superior to other similar studies and can be used for screening and clinical auxiliary diagnosis of gastric cancer among middle-aged and elderly populations.
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