Stomach cancer screening and prevention
Common Early Symptoms (Can mimic other issues)
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Bloating: Feeling full or swollen in the abdomen, even after eating small amounts.
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Stomach Pain: Discomfort or cramps, often above the navel.
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Loss of Appetite: Not feeling hungry or losing interest in food.
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Indigestion/Heartburn: A burning feeling or discomfort in the chest or stomach that doesn't go away.
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Nausea: Feeling sick to your stomach.
Later-Stage or More Specific Symptoms
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Unexplained Weight Loss: Losing weight without trying.
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Vomiting: May include blood, which can look bright red or dark brown (like coffee grounds).
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Fatigue: Feeling unusually tired or weak.
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Difficulty Swallowing: Food getting stuck, or pain when swallowing.
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Changes in Bowel Habits: Black, tarry, or bloody stools.
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Jaundice: Yellowing of the skin or eyes.
EGD for stomach Cancer Prevention
Best Practices for High-Quality Endoscopy (When Screening is Done)
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High-Definition Endoscopy: Use image enhancement for better visualization.
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Mucosal Cleansing: Ensure stomach is clean for optimal view.
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Systematic Biopsy: Follow protocols (like the Sydney System) for accurate diagnosis and staging.
For Average Risk (U.S.)
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Diagnosis usually occurs after symptoms appear, prompting tests like upper endoscopy.
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Major U.S. organizations don't recommend general population screening because benefits don't outweigh harms (like unnecessary procedures).
For High-Risk Individuals
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Who:
First-generation immigrants from high-risk areas (Japan, Korea, China, etc.), family history of gastric cancer, certain genetic syndromes (Lynch, FAP), severe atrophic gastritis (GA), or intestinal metaplasia (GIM).
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Method:
Upper endoscopy (EGD) is the gold standard, allowing visualization and biopsies for staging precancerous conditions.
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Key Findings:
Look for GA, GIM, or dysplasia.
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Surveillance:
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GA/GIM: Consider surveillance (e.g., every 3 years) for severe atrophy or extensive GIM, especially with other risk factors.
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Family History: Consider screening (endoscopy) for first-degree relatives of GC patients.
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