Early gastric cancer is defined as adenocarcinoma confined to the mucosa or submucosa irrespective of lymph node involvement. In Japan, mucosal high-grade neoplasia is diagnosed as intramucosal early gastric cancer. Some early gastric cancers progress to advanced gastric cancer after several years of follow-up. Image-enhanced endoscopy (chromoendoscopy), narrow-band imaging, and magnifying endoscopy increase the diagnostic yield in characterizing early gastric cancer. Endoscopic resection of intramucosal early gastric cancer with endoscopic mucosal resection or endoscopic submucosal dissection is currently performed in East Asian countries to prevent the development of advanced gastric cancer and preserve patients’ quality of life after treatment.
Key points
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Early gastric cancer is defined as adenocarcinoma confined to the mucosa or submucosa irrespective of lymph node involvement. In Japan, mucosal high-grade neoplasia is diagnosed as intramucosal early gastric cancer.
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Some early gastric cancers progress to advanced gastric cancer after several years of follow-up.
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A proper endoscopic screening procedure would increase the detection of intramucosal early gastric cancer.
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Image-enhanced endoscopy (ie, chromoendoscopy), narrow-band imaging, and magnifying endoscopy increase the diagnostic yield for characterization of early gastric cancer.
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Endoscopic resection of intramucosal early gastric cancer with endoscopic mucosal resection or endoscopic submucosal dissection is currently performed in East Asian countries to prevent the development of advanced gastric cancer and to preserve patients’ quality of life after treatment.
Background
Gastric cancer is currently the fourth most common malignancy and the second most common cause of cancer deaths worldwide. Half the global total of gastric cancer occurs in East Asia. Age-standardized mortality rate is estimated as the highest (28.1 per 100,000 in men and 13.0 per 100,000 in women) in East Asia, whereas that in the United States is low (2.8 per 100,000 in men and 1.5 per 100,000 in women). Early detection and treatment are considered to be effective strategies in reducing mortality from gastric cancer as a secondary prevention. Thus, many attempts have been made in this direction, such as encouragement of mass screening or the development of accurate diagnostic procedures in East Asian countries.
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