Screening
Endoscopy is the best test for screening or surveillance in individuals at increased risk for gastric cancer.[11] Mass screening programmes for gastric cancer have been implemented in countries with a high incidence of the disease, such as Japan and Chile. However, it is not cost-effective to screen asymptomatic people in countries where there is a low incidence of gastric cancer. Consider screening high-risk groups, such as first-generation immigrants from high-incidence regions, individuals with first-degree relatives with stomach cancer, individuals from non-white racial and ethnic groups with established moderate to high incidence of stomach cancer, and individuals with certain hereditary gastrointestinal polyposis or hereditary cancer syndromes (e.g., CDH1 germline mutation in hereditary diffuse gastric cancer syndrome).[11][46] Opportunistic screening for Helicobacter pylori infection should also be considered for these high-risk individuals.[11]
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