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Results and prospectives of a mass-screening for gastric cancer and precancerous lesions of the stomach

Résultats et prospectives d'un dépistage en masse du cancer gastrique et des lésions précancéreuses de l'estomac

  • Published:
Acta Endoscopica

Summary

Selection and follow-up of «high risk» population groups must be considered as the first step in cancer control. A project for mass screening for gastric cancer has been in process since 1968 by the Gastro-enterology Unit of the Regina Elena Institute for Cancer Research.

For the stomach, chronic gastritis with atrophic changes and intestinal metaplasia have shown a statistically significant association with cancer and represent, from a biological viewpoint, an almost mandatory step in carcinogenesis.

26.712 asymptomatic subjects were tested for stomach acidity in our Unit by simple laboratory examinations, and 4.432 who evidenced impaired acid secretion were submitted to blind abrasive gastric cytology by a special retractable nylon brush. Following the special parameters used for cytology, 709 of these subjects were classified as «high risk».

Endoscopic examinations performed on this latter group permitted us to show a very significant gastric pathology in comparison with the control group, including 8 cases of early gastric cancer, and one «in situ» carcinoma.

Besides this, the clinical, radiological and endoscopical examination performed on a population group of symptomatic subjects allowed us to diagnose 80 gastric cancers, 28 gastric ulcers, 15 cases of polyposis and 3 cases of Menetriere's disease.

The kind of mass-screening that we perform, clearly appears to give valuable results for early diagnosis of gastric cancer and for selection of «high risk» subjects.

Résumé

La sélection et la surveillance de groupes de population à «haut risque» doivent être considérées comme le premier pas pour le dépistage du cancer. Au sein du Service de gastroentérologie de l'Institut Regina Elena de Roma, un projet de dépistage pour le cancer gastrique est à l'étude depuis 1968.

Pour l'estomac, la gastrite chronique accompagnée d'atrophie et de métaplasie intestinale s'est avérée être associée d'une manière statiquement significative au cancer, et représente, également du point de vue biologique, une étape presque obligée de la carcinogenèse.

Au sein de notre Centre, l'acidité gastrique de 26 712 sujets asymptomatiques a été examinée à l'aide de simples examens de laboratoire, et 4 432 qui avaient une sécrétion acide diminuée ont été soumis à une étude cytologique abrasive de l'estomac. Selon les paramètres particuliers employés pour la cytologie, 709 de ces sujets ont été catalogués comme des «hauts risques».

Les examens endoscopiques pratiqués sur ce dernier groupe ont permis de découvrir une pathologie gastrique très significative, par rapport aux contrôles, y compris 8 cancers gastriques initiaux et 1 cancer «in situ».

Par contre, l'examen clinique, radiologique et endoscopique d'un groupe de population de sujets symptomatiques a permis de diagnostiquer 80 cancers de l'estomac, 28 ulcères gastriques, 15 cas de polypose et 3 cas de maladie de Ménétrier.

Le modèle de dépistage adopté semble donc bien en mesure de donner des résultats appréciables pour le diagnostic précoce du cancer et pour la sélection des sujets à «haut risque».

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Authors and Affiliations

  1. Cancer Detection Center, Regina Elena Institute for Cancer Research, Viale Regina Elena, 2919, Roma, Italy

    M. Crespi, V. Casale, A. Grassi & C. Maggio

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  1. M. Crespi
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  2. V. Casale
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  3. A. Grassi
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  4. C. Maggio
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XIIIth S.M.I.E.R. International Congress, Lyon (France), 6–8/V1976.

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Crespi, M., Casale, V., Grassi, A. et al. Results and prospectives of a mass-screening for gastric cancer and precancerous lesions of the stomach. Acta Endosc 8, 73–85 (1978). https://doi.org/10.1007/BF02970276

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  • DOI: https://doi.org/10.1007/BF02970276

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