Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
Department of Gastroenterology, Digestive Diseases Centre GASTRO, Riga, Latvia.
Gut. 2024 Nov 11;73(12):2074-2082. doi: 10.1136/gutjnl-2024-332705.
The absolute number of annual cases of gastric cancer in Europe is rising. The Council of the European Union has recommended implementation of gastric cancer screening for countries or regions with a high gastric cancer incidence and death rates. However, as of 2024 no organised gastric cancer screening programme has been launched in Europe.There are several ways to decrease gastric cancer burden, but the for ) seems to be the most appropriate for Europe. It has to be noted that increased use of antibiotics would be associated with this strategy.Only organised population-based cancer screening is recommended in the European Union, therefore gastric cancer screening also is expected to fulfil the criteria of an organised screening programme. In this respect, several aspects of screening organisation need to be considered before full implementation of gastric cancer prevention in Europe; the age range of the target group, test types, eradication regimens and surveillance strategies are among them. Currently, ongoing projects (GISTAR, EUROHELICAN, TOGAS and EUCanScreen) are expected to provide the missing evidence. Feedback from the decision-makers and the potential target groups, including vulnerable populations, will be important to planning the programme.This paper provides an overview of the recent decisions of the European authorities, the progress towards gastric cancer implementation in Europe and expected challenges. Finally, a potential algorithm for gastric cancer screening in Europe is proposed.
欧洲每年胃癌的绝对病例数正在上升。欧盟理事会建议对胃癌发病率和死亡率高的国家或地区实施胃癌筛查。然而，截至 2024 年，欧洲尚未启动有组织的胃癌筛查计划。有几种方法可以降低胃癌负担，但在欧洲，似乎（根除）是最合适的方法。需要注意的是，这种策略的实施可能会伴随着抗生素使用的增加。欧盟仅推荐有组织的基于人群的癌症筛查，因此胃癌筛查也有望符合有组织筛查计划的标准。在这方面，在欧洲全面实施胃癌预防之前，需要考虑筛查组织的几个方面；其中包括目标人群的年龄范围、检测类型、（根除）方案和监测策略。目前，正在进行的项目（GISTAR、EUROHELICAN、TOGAS 和 EUCanScreen）有望提供缺失的证据。决策者和潜在目标群体（包括弱势群体）的反馈对于规划该计划至关重要。本文概述了欧洲当局的最新决定、在欧洲实施胃癌筛查的进展以及预期的挑战。最后，提出了一种在欧洲进行胃癌筛查的潜在算法。
