Symptoms, Screening & Early Detection

Screening and Early Detection

In parts of Asia where stomach cancer is highly prevalent, aggressive screening programs have had some success in detecting early cancers and improving the outcomes. In the United States, there are no effective screening methods and no established programs for primary prevention or early detection. In addition, the symptoms of stomach cancer are not specific and are common to many gastric problems such as ulcers and gastritis. They include abdominal discomfort, indigestion, loss of appetite, occasional vomiting, and a feeling of fullness after eating small amounts of food. Up to 25% of patients will have a history of gastric ulcers.

Up to now screening programs have relied on tests known as “upper GIs” or barium swallows and upper endoscopies. These procedures are somewhat analogous to the use of colonoscopy to detect pre-cancerous and early cancerous colon and rectal lesions. Because of the low incidence of stomach cancer in this country combined with the high cost of these tests, most experts believe that wide-scale screening for stomach cancer would cause more problems than it would solve. More recent studies have investigated the use of a blood marker called the serum pepsinogen I/II ratio to detect atrophic gastritis and gastric cancer, but this approach is still in the very early stages of investigation.

Symptoms

The symptoms of stomach cancer can include any or all of the following:

• Indigestion and stomach discomfort
• A bloated feeling after eating
• Mild nausea
• Loss of appetite
• Heartburn
• Fatigue
• Blood in the stool/black tarry stool
• Vomiting
• Weight loss for no known reason
• Stomach pain
• Jaundice (yellowing of eyes and skin)
• Ascites (build-up of fluid in the abdomen)
• Trouble swallowing