An Approach to the Primary and Secondary Prevention of Gastric Cancer in the United States. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Huang, R. J., Epplein, M., Hamashima, C., Choi, I. J., Lee, E., Deapen, D., Woo, Y., Tran, T., Shah, S. C., Inadomi, J. M., Greenwald, D. A., Hwang, J. H. 2021


/Aims: Gastric cancer (GC) remains a leading cause of mortality among certain racial, ethnic, and immigrant groups in the United States (US). The majority of GCs are diagnosed at advanced stages, and overall survival remains poor. There exist no structured national strategies for GC prevention in the US.On March 5-6, 2020 a Summit of researchers, policy makers, public funders, and advocacy leaders was convened at Stanford University to address this critical healthcare disparity. Following this Summit, a writing group was formed to critically evaluate the effectiveness, potential benefits, and potential harms of methods of primary and secondary prevention through structured literature review. This White Paper represents a consensus statement prepared by the writing group.The burden of GC is highly inequitably distributed in the US, and disproportionately falls on Asian, African American, Hispanic, and American Indian/Alaskan Native populations. In randomized controlled trials, strategies of Helicobacter pylori testing and treatment have been demonstrated to reduce GC-specific mortality. In well-conducted observational and ecological studies, strategies of endoscopic screening have been associated with reduced GC-specific mortality. Notably however, all randomized controlled trial data (for primary prevention), and the majority of observational data (for secondary prevention) are derived from non-US sources.There exists substantial, high-quality data supporting GC prevention derived from international studies. There is an urgent need for cancer prevention trials focused on high-risk immigrant and minority populations in the US. The authors offer recommendations on how strategies of primary and secondary prevention can be applied to the heterogeneous US population.

View details for DOI 10.1016/j.cgh.2021.09.039

View details for PubMedID 34624563