Screening for gastric cancer in China: Advances, challenges and visions.
Screening for gastric cancer in China: Advances, challenges and visions.
复制标题
中国胃癌的筛查：进步，挑战和视觉。
DOI：
10.21147/j.issn.1000-9604.2021.02.05
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发表时间：
2021-04-30
期刊：
影响因子：
--
通讯作者：
Pan K
中科院分区：
文献类型：
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作者：
Fan X;Qin X;Zhang Y;Li Z;Zhou T;Zhang J;You W;Li W;Pan K
胃癌是中国和世界范围内的主要癌症之一。大多数GCs确诊时已进入晚期，预后不良。中国与其他一些国家一起，开发了政府资助的胃癌和其他主要癌症的国家筛查项目。在采用全国性筛查计划的国家(日本和韩国)以及基于选定的中国人群的研究中，GC筛查已被证明有效地降低了GC的发病率和死亡率。胃癌的筛查主要依靠胃镜检查，以往的研究表明胃镜检查的准确性、可靠性和安全性已得到证实。然而，考虑到其侵入性筛查方法，对熟练的内窥镜医生和病理学家的要求，以及高昂的成本，开发非侵入性方法来改进内窥镜筛查将是非常必要的。许多研究已经检查了用于GC筛查的生物标记物，涉及胃蛋白酶原、胃泌素和幽门螺杆菌抗体的生物标记物的组合已被提出用于风险分层，试图缩小进一步内窥镜检查的高危人群范围。尽管内窥镜筛查取得了所有成就，但关于合适的筛查年龄、重复筛查的间隔时间、促进精准预防的新生物标志物以及卫生经济学的证据仍需积累，以向中国的政策制定者通报内窥镜筛查。在《健康中国2030年规划纲要》的指引下，推进胃癌防治工作面临千载难逢的机遇。本文总结了中国等东亚国家胃癌筛查项目的特点，介绍了过去和现在的胃癌筛查方法和策略，旨在介绍胃癌筛查的最新进展和面临的关键挑战，并对未来胃癌筛查的前景进行展望。
Gastric cancer (GC) is one of the major cancers in China and all over the world. Most GCs are diagnosed at an advanced stage with unfavorable prognosis. Along with some other countries, China has developed the government-funded national screening programs for GC and other major cancers. GC screening has been shown to effectively decrease the incidence of and mortality from GC in countries adopting nationwide screening programs (Japan and Korea) and in studies based on selected Chinese populations. The screening of GC relies mostly on gastroendoscopy, the accuracy, reliability and safety of which have been indicated by previous studies. However, considering its invasive screening approach, requirements on skilled endoscopists and pathologists, and a high cost, developing noninvasive methods to amend endoscopic screening would be highly needed. Numerous studies have examined biomarkers for GC screening and the combination of biomarkers involving pepsinogen, gastrin, and Helicobacter pylori antibodies has been proposed for risk stratification, seeking to narrow down the high-risk populations for further endoscopy. Despite all the achievements of endoscopic screening, evidence on appropriate screening age, intervals for repeated screening, novel biomarkers promoting precision prevention, and health economics need to be accumulated to inform policymakers on endoscopic screening in China. With the guide of Health China 2030 Planning Outline, we have golden opportunities to promote prevention and control of GC. In this review, we summarize the characteristics of screening programs in China and other East Asian countries and introduce the past and current approaches and strategies for GC screening, aiming for featuring the latest advances and key challenges, and illustrating future visions of GC screening.