Understanding Early-Stage Gastric Cancer: Detection and Treatment Options

Gastric cancer is one of the most life-threatening malignant tumors worldwide, with approximately 1.09 million new cases diagnosed annually. In China alone, nearly 410,000 new cases are reported each year, meaning about 1,300 people are diagnosed daily. The survival rate of gastric cancer patients is closely tied to the stage at diagnosis. Early-stage gastric cancer has a cure rate of up to 90%, while the cure rate drops significantly to around 30% for late-stage cases. Therefore, early detection and treatment are crucial in reducing mortality rates. Thanks to advancements in endoscopic technology and the widespread implementation of screening programs, early detection of gastric cancer is becoming more achievable.

What Is Early-Stage Gastric Cancer?
Early gastric cancer refers to cancer that is localized and has not deeply infiltrated the stomach wall. It is defined pathologically as cancer confined to the mucosa or submucosa, regardless of tumor size or lymph node involvement. This category also includes high-grade dysplasia and intraepithelial neoplasia. Tumors are further classified by size: small cancers (6–10 mm), minute cancers (≤5 mm), and pinpoint cancers, where cancer cells are detected in biopsies but not found in surgical specimens.

Common Symptoms of Early Gastric Cancer
Most early-stage gastric cancers do not present noticeable symptoms. When symptoms do occur, they are often nonspecific and similar to common gastrointestinal issues, such as indigestion, bloating, early satiety, loss of appetite, acid reflux, and belching. Because these signs are easily mistaken for benign conditions, many cases go undetected until the disease progresses. Individuals over the age of 40 experiencing persistent digestive discomfort should consider a medical evaluation, including endoscopic examination, to rule out gastric cancer.

How to Detect Early Gastric Cancer
China has developed a national consensus on gastric cancer screening protocols to improve early diagnosis. High-risk individuals—such as those with Helicobacter pylori infection, a family history of gastric cancer, long-term smoking habits, or a diet high in preserved foods—should undergo regular screening. Initial screening often involves serum testing for biomarkers like pepsinogen I, pepsinogen II, and gastrin-17, along with H. pylori antibody testing. Those identified as high-risk are then recommended for high-definition endoscopic examination.

Gastric Function Testing and Risk Assessment
Gastric function testing helps assess the health of the stomach lining and detect abnormalities that may indicate cancer risk. A scoring system based on test results, combined with age, gender, and H. pylori status, helps classify individuals into low, medium, or high-risk categories. High-risk individuals (scoring 17–23) should undergo annual endoscopic exams, while medium-risk individuals (12–16) are advised to have exams every two years. This approach optimizes resource use and improves early detection rates.

What Is High-Definition Endoscopy?
High-definition endoscopy involves detailed imaging techniques such as chromoendoscopy, magnifying endoscopy, and confocal laser endomicroscopy. These methods allow specialists to analyze suspicious lesions in real-time and determine whether a biopsy is necessary. The procedure is typically performed under sedation by experienced endoscopists using advanced imaging equipment. It provides critical information about tumor depth, spread, and differentiation, which helps determine the best treatment strategy.

Treatment Options for Early-Stage Gastric Cancer
Endoscopic resection is the preferred treatment for early gastric cancer. Techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) offer minimally invasive alternatives to traditional surgery. These methods reduce recovery time, lower complication risks, and maintain similar cure rates. For more advanced early-stage cases, laparoscopic or open surgery may be necessary to ensure complete removal and lymph node clearance.

In conclusion, while gastric cancer poses a serious health threat, early detection and timely treatment can lead to full recovery. High-risk individuals over 40 should prioritize regular screenings, including gastroscopy, as part of their health routine. Detecting gastric cancer at an early stage not only saves lives but also preserves quality of life.