Detection and treatment of early gastric cancer in the West

Nevertheless, it is still possible to identify high-risk groups of patients who should be referred early for investigation by means of endoscopy and biopsy. The first group of high-risk patients are those with conditions such as pernicious anaemia, gastric ulcer, chronic atrophic gastritis, intestinal metaplasia, or those who have had partial gastrectomy or vagotomy and gastroenterostomy in the past. The second and perhaps more important group of patients are those with dyspepsia who are over 40 years of age. It is estimated that approximately 30% of the population suffer from dyspepsia at any time and, of these, a third will consult their general practitioner. Patients over the age of 40-45 years with dyspepsia have a 1 in 50 chance of having gastric cancer. 3 If such patients are referred promptly, a quarter of the gastric cancers detected will be early gastric cancers and over half of the patients would be suitable for potentially curative resection