Pioneering Early Detection and Patient-Centered Care

November marks Gastric Cancer Awareness Month, an opportunity to highlight one of the world’s most prevalent and challenging cancers. Gastric cancer remains the fifth most common cancer globally and the fourth leading cause of cancer-related deaths. In 2020, there were over 1.08 million new cases and approximately 769,000 deaths worldwide due to gastric cancer^[1].

While incidence rates have been declining in some regions, there has been a concerning rise in early‑onset gastric cancer among individuals under 50, particularly women^[2]. Survival outcomes remain strongly linked to the stage at diagnosis. When detected early, five‑year survival rates can exceed 90%; in advanced stages, they can drop below 30%^[3].

Despite advances, many patients are still diagnosed late because early gastric cancer is often asymptomatic or presents with vague symptoms like indigestion or mild discomfort. Screening practices vary widely between countries, contributing to disparities in early detection and outcomes^[4]. These realities underline the need for early detection strategies, precise diagnostics, and innovative treatment options that can change patient trajectories.

To provide expert insight into the latest advances in this field, we spoke with Prof. Raf Bisschops, experienced gastroenterologist and professor of medicine at UZ Leuven (Belgium) and President-Elect of the ESGE (European Society of Gastrointestinal Endoscopy).

Q&A with Prof. Bisschops

Q1: What are the key challenges in gastric cancer today?

Prof. Bisschops: Gastric cancer often develops without clear warning signs. Many patients have vague or nonspecific symptoms, so diagnosis frequently occurs at a late stage. Identifying individuals at higher risk and improving early detection strategies are essential to improving outcomes. We can do that during daily endoscopy to identify those patients at risk with diffuse intestinal metaplasia by conducting high quality endoscopy as a routine practice.

Q2: How are advances in endoscopy transforming patient care?

Prof. Bisschops: There is an increased emphasis on quality in endoscopy that started for colonoscopy but now also applies to upper GI endoscopy. On the one hand this entails simple measures like cleaning the mucosa with simethicone and water during the procedure and ensuring sufficient inspection time and mucosal exposure that should be photo documented. On the other hand, the image quality of contemporary high-definition endoscopy has increased significantly. In conjunction with virtual chromoendoscopy this enables endoscopists to better detect intestinal metaplasia and subtle lesions and to identify patients at risk.

Q3: What recent innovations in the field excite you most?

Prof. Bisschops: Detecting subtle lesions remains very challenging and difficult. The recent development of artificial intelligence in this field looks promising and has the potential to bring an expert eye into every endoscopy room during each endoscopy. However, the recent interest in improving overall quality of upper GI endoscopy will become even more pivotal for such systems to actually work: if mucosal exposure is poor, nothing will be detected.

In addition, the development of non-invasive breath and blood test to screen for cancer are also very promising.

Q4: What message would you like to share during Gastric Cancer Awareness Month?

Prof. Bisschops: Raising awareness is just as important as technological progress and improving the quality of everyday endoscopy. If patients and healthcare systems act early, we can catch gastric cancer at a stage where organ saving endoscopic treatment is feasible. Collaboration between clinicians, researchers, and industry partners is key to driving meaningful change.

PENTAX Medical: Industry Perspective

At PENTAX Medical, we empower healthcare professionals with intuitive flexible endoscopy solutions for better patient care. From high-definition imaging platforms to advanced therapeutic tools, our innovations help clinicians detect subtle lesions, make accurate diagnoses, and deliver personalized treatment options.

This Gastric Cancer Awareness Month, we stand alongside clinicians, researchers, patients, and advocacy organizations to raise awareness and advance care. Every screening, every conversation, and every technological innovation brings us closer to earlier detection and improved survival.

For more information on gastric cancer research and awareness initiatives, visit https://digestivecancers.eu/gastric-esophageal-what/.

[1] Lin JL, et al. Global incidence and mortality trends of gastric cancer and their implications. BMC Public Health. 2024. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19104-6

[2] Deane C, et al. Global, regional, and national burden of early‑onset gastric cancer. Cancer Biomed. 2024. Available from: https://www.cancerbiomed.org/content/early/2024/08/07/j.issn.2095-3941.2024.0159

[3] Lin JL, et al. Global incidence and mortality trends of gastric cancer and their implications. BMC Public Health. 2024. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-19104-6

[4] Shiratori Y, et al. Disparities in gastric cancer screening worldwide. Cancer Screening and Prevention. 2024. Available from: https://www.xiahepublishing.com/2835-3315/CSP-2024-00008