Screening strategies for the early detection of non-cardia gastric cancer in low- to moderate-prevalence regions: Asia-Pacific gastroesophageal cancer congress consensus 2026

BACKGROUND: Gastric cancer (GC) remains a major global health burden, and early detection is essential for improving patient outcomes. Although GC screening has been widely implemented in East Asian countries with a high disease burden, the optimal screening strategy for low- to moderate-prevalence regions remains unclear. To address this gap, the Asia Pacific Gastroesophageal Cancer Congress (APGCC) convened an international consensus meeting to develop evidence-based recommendations for improving the detection of non-cardia gastric cancer (NCGC). METHODS: The APGCC working group developed 11 clinical questions (CQs) addressing GC screening, with a particular focus on NCGC. For each CQ, assigned authors conducted literature reviews using PubMed and prepared evidence summaries and draft recommendations. Consensus was achieved through a two-round modified Delphi process involving 37 international voting members. RESULTS: The consensus recommendations addressed population-based screening, screening modalities, identification of high-risk individuals, quality indicators for esophagogastroduodenoscopy (EGD), image-enhanced endoscopy, and artificial intelligence-assisted endoscopy. Population-based endoscopic screening is not recommended in low- to moderate-prevalence regions because of insufficient evidence. However, if screening is performed, EGD is preferred over upper gastrointestinal series for the detection of early NCGC in asymptomatic individuals. The recommendations also emphasize the importance of high-quality endoscopic examinations, risk-stratified screening using serum biomarkers, and the appropriate integration of advanced endoscopic technologies. CONCLUSIONS: These APGCC consensus recommendations provide practical guidance for improving the early detection of NCGC in low- to moderate-prevalence regions. This consensus also highlights important evidence gaps and establishes a framework for future research and the development of region-specific GC screening strategies.

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Journal
Gastric Cancer
Published
2026-10-14
DOI
https://doi.org/10.1007/s10120-026-01800-4
Primary Topic
Gastric Cancer Management and Outcomes
Type
article
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article

Screening strategies for the early detection of non-cardia gastric cancer in low- to moderate-prevalence regions: Asia-Pacific gastroesophageal cancer congress consensus 2026

Mitsuru Esaki, Takuji Gotoda, Yhi Wong, Motohiko Kato et al.
Gastric Cancer
Gastric Cancer Management and Outcomes
article

Screening strategies for the early detection of non-cardia gastric cancer in low- to moderate-prevalence regions: Asia-Pacific gastroesophageal cancer congress consensus 2026

Mitsuru Esaki, Takuji Gotoda, Yhi Wong, Motohiko Kato, Seiichiro Abe, Vo Duy Long, Kamin Harinwan, Chul S. Hyun, Hon Chi Yip, Robert Bechara, Vincenzo Giorgio Mirante, Sabina Beg, Pedro Delgado‐Guillena, Quang Dinh Le, Renata Nobre Moura, P Kassab, Rapat Pittayanon, Marta Rodríguez-Carrasco, Ayaka Takasu, Grigorios Christodoulidis, Seung‐Hun Chon, Duc Trong Quach, Fumiaki Ishibashi, Waku Hatta, Adolfo Parra‐Blanco, Kohei Takizawa, Hyunsoo Chung, Do Hoon Kim, Regina Rie Imada, Sho Suzuki, James Weiquan Li, Han-Kwang Yang, Matsuda Satoru, Roman Kuvaev, Zili Xiao, Wai Keung Leung, Joo Ha Hwang, Sergey Kashin, José Murillo-Rodriguez, Munkhsaruul Bayaraa
article en

Abstract

BACKGROUND: Gastric cancer (GC) remains a major global health burden, and early detection is essential for improving patient outcomes. Although GC screening has been widely implemented in East Asian countries with a high disease burden, the optimal screening strategy for low- to moderate-prevalence regions remains unclear. To address this gap, the Asia Pacific Gastroesophageal Cancer Congress (APGCC) convened an international consensus meeting to develop evidence-based recommendations for improving the detection of non-cardia gastric cancer (NCGC). METHODS: The APGCC working group developed 11 clinical questions (CQs) addressing GC screening, with a particular focus on NCGC. For each CQ, assigned authors conducted literature reviews using PubMed and prepared evidence summaries and draft recommendations. Consensus was achieved through a two-round modified Delphi process involving 37 international voting members. RESULTS: The consensus recommendations addressed population-based screening, screening modalities, identification of high-risk individuals, quality indicators for esophagogastroduodenoscopy (EGD), image-enhanced endoscopy, and artificial intelligence-assisted endoscopy. Population-based endoscopic screening is not recommended in low- to moderate-prevalence regions because of insufficient evidence. However, if screening is performed, EGD is preferred over upper gastrointestinal series for the detection of early NCGC in asymptomatic individuals. The recommendations also emphasize the importance of high-quality endoscopic examinations, risk-stratified screening using serum biomarkers, and the appropriate integration of advanced endoscopic technologies. CONCLUSIONS: These APGCC consensus recommendations provide practical guidance for improving the early detection of NCGC in low- to moderate-prevalence regions. This consensus also highlights important evidence gaps and establishes a framework for future research and the development of region-specific GC screening strategies.

Gastric Cancer
Nihon University (JP), Nottingham University Hospitals NHS Trust (GB), Kyushu University (JP), Seoul National University (KR), Chulalongkorn University (TH), Chinese University of Hong Kong (HK), University of Cologne (DE), Yaroslavl State University (RU), Tohoku University (JP), Keio University (JP), Yaroslavl State Medical Academy (RU), Fudan University (CN), Santa Casa Hospital (BR), Asan Medical Center (KR), King Chulalongkorn Memorial Hospital (TH), University of Medicine and Pharmacy at Ho Chi Minh City (VN), Costa Rican Department of Social Security (CR), Yale University (US), University of Ulsan (KR), Irmandade da Santa Casa de Misericórdia de São Paulo (BR), Phramongkutklao Hospital (TH), Instituto do Câncer do Estado de São Paulo (BR), Azienda Ospedaliera Universitaria Integrata Verona (IT), Huadong Hospital (CN), Tokyo Dental College Ichikawa General Hospital (JP), University Medical Center HCMC (VN), SHOWA Medical University Northern Yokohama Hospital (JP), Keio University Hospital (JP), University Hospital of Larissa (GR), IPO Porto (PT), National Cancer Center (KR), NIHR Nottingham Digestive Diseases Biomedical Research Unit (GB), East and North Hertfordshire NHS Trust (GB), Stanford Medicine (US), University Hospital Cologne (DE), Kingston Health Sciences Centre (CA), Sengkang General Hospital (SG), SHOWA Medical University Hospital (JP), Japanese Foundation For Cancer Research (JP), Kanagawa Cancer Center, Phramongkutklao College of Medicine, Bệnh viện Nhân dân Gia Định (VN), National Cancer Center Hospital (JP), International University of Health and Welfare (JP), University of Hong Kong (HK), Stanford University (US)
Good health and well-being
Openalex Percentile: Top 14%
Gastric Cancer Management and Outcomes
DOIOpen Access PDFOpenAlex
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