The subject of screening is a topical one in Japan, where the incidence of the disease is so high. Here, it has been shown that a diagnosis of early cancer is attended by vastly better survival chances. The screening studies have been by either indirect radiology (barium studies) or endoscopy.
There is no doubt that if the disease is picked up at a very early stage, the patient stands a good chance of cure whereas the majority of patients with advanced disease at presentation succumb from the illness. The problem in the UK is that the disease is sufficiently uncommon, and the required screening test sufficiently uncomfortable and labour intensive that the health economics and the likelihood of population co-operation stack up heavily against he introduction of such a screening programme.
Having said this, there is good reason to refer every patient over forty with dyspepsia, in all its formats, for screening endoscopy/gastroscopy.
