Gastric cancer – also known as stomach cancer – is highly treatable when it is identified early in its disease course. But in countries like the U.S. where gastric cancer is relatively rare, screening for the disease is not common. This leads to patients often being diagnosed at a stage when their cancer is advanced and cannot be cured. With a new one-year Cancer Center Support Grant Program Pilot from the UW Carbone Cancer Center, Division of Surgical Oncology Professor Kaitlyn Kelly, MD, MAS will test the effectiveness of a simple patient questionnaire to determine if a patient has symptoms or a family history that would warrant screening for gastric cancer at the same visit for colon cancer screening.
“Colon cancer screenings are recommended and performed in the U.S. for all patients age 45 and older. Since colonoscopies are common and involve consultation with a gastroenterologist, there is an opportunity to selectively add an upper endoscopy to the patient visit when it is indicated,” explained Kelly. “An upper endoscopy is essentially the only test to identify an early-stage, intramucosal or mucosal gastric cancer.”
Upper endoscopies are minimally invasive medical procedures that use a thin, flexible tube with a camera to examine the lining of the esophagus, stomach, and the first part of the small intestine. Because the procedure requires the patient to lie on their side and be sedated, it can be efficiently performed at the same time as colon cancer screening.
Kelly developed a five-item questionnaire based on both current guidelines for upper endoscopy and data gathered from patients with gastric cancer. She plans to administer this questionnaire to UW patients who are scheduled for an upcoming screening colonoscopy. A “Yes” answer to any one of the questions would trigger adding an upper endoscopy to the scheduled colonoscopy. Her study will determine how often an upper endoscopy is added based on the questionnaire, how often the procedure identifies lesions that require intervention or follow-up, and the cost to the healthcare system for this added procedure.
“There is a dire need for earlier diagnosis of gastric cancer in the United States,” said Kelly. “If this pilot study shows that a simple questionnaire can successfully identify UW patients who should be screened for gastric cancer at the time of their screening colonoscopy – and that it does so in a way that is cost-effective and does not overload the healthcare system – then we can take this protocol and test it on a larger scale.”