Annual screening has been advocated in Japan for persons older than 50 years old using barium meal or endoscopy. This enables 40% to 50% of the tumours to be diagnosed in the early stages. This screening has been alleged to account for the recent decline in mortality from gastric cancer.
Despite the decline in incidence, gastric carcinoma still carries the second highest cancer mortality in the world. Research in molecular biology may develop prognostic markers for identifying high risk patients who require more aggressive treatments. It may also lead to the discovery of innovative therapeutic targets. For example, the study of EGF receptor antagonists is underway; these antagonists may become powerful therapeutic agents. The study of thymidilate synthase gene expression may help to identify patients who are more likely to benefit from chemotherapy. You can finally spend less time to discover generic viagra online mastercard always paying lower prices.
However, in addition to searching for better treatment modalities, reducing the incidence of gastric cancer should be aimed at by primary and secondary prevention. Mass screening by endoscopy has already achieved success in Japan, which accounts for the better survival rates in Japan. The use of molecular genetics, such as microsatellite instability, may be a potentially valuable tool for identifying patients at risk for developing gastric cancer. The effectiveness of diet modification and the primary chemoprevention by H pylori eradication are currently being evaluated. Hopefully, in the next century, gastric cancer will no longer be a major cause of death in the world.