Gastroscopy Should Be Performed for 'At Least 3 Minutes' to Reduce the Risk of 'Intermediate Gastric Cancer'

Professor Team of Kim Tae-jun, Lee Joon-haeng, and Pyo Jung-ui at Samsung Seoul Hospital

A study has found that the observation time of the stomach during gastroscopy should be 'at least 3 minutes' to reduce the risk of developing 'interval gastric cancer.'

Endoscopy reference photo. [Image source=Getty Images]

The research team led by Professors Kim Tae-jun and Lee Jun-haeng from the Department of Gastroenterology at Samsung Medical Center, along with Professor Pyo Jeong-ui from the Health Medical Headquarters, announced on the 8th that they confirmed this by studying patients who were diagnosed with advanced gastric cancer within 6 months to 3 years after receiving a negative result for gastric cancer through gastroscopy.

Gastroscopy is an effective examination method for early detection of gastric cancer and reducing gastric cancer mortality. In particular, interval gastric cancer is cancer diagnosed after regular gastroscopy screenings, and among interval gastric cancers, advanced gastric cancer is a significant issue related to gastric cancer mortality.

Previous reports indicate that about 10% of newly diagnosed gastric cancer patients had undergone endoscopy within 3 years prior to diagnosis and were classified as interval cancers. In countries like Korea, where gastroscopy is regularly performed every 1 to 3 years for early detection, advanced gastric cancer diagnosed after endoscopy holds clinical significance as 'interval gastric cancer.'

[Photo by Samsung Seoul Hospital]

The research team analyzed 1,257 patients who had negative gastric cancer results from endoscopy between 2005 and 2021 but were diagnosed with gastric cancer within 6 to 36 months. They investigated related variables such as age, sex, family history of gastric cancer, Helicobacter pylori infection status, and endoscopic findings, and included stomach observation time and endoscopy interval as quality indicators of endoscopy to analyze predictive factors for advanced interval gastric cancer.

As a result, among various predictive variables, 'short stomach observation time' (less than 3 minutes) and 'endoscopy intervals exceeding 2 years' showed a significant association with the risk of developing advanced interval gastric cancer. The research team emphasized that the stomach observation time should be at least 3 minutes, and the total endoscopic observation time should be 4 to 5 minutes or more. Additionally, about one-quarter of patients with advanced interval gastric cancer had Borrmann type IV gastric cancer, and two-thirds of these were female. The cancer mortality rate associated with Borrmann type IV was 63%, which is considerably higher compared to the 26% mortality rate of other types of gastric cancer.

Professor Kim Tae-jun explained, "To reduce advanced interval gastric cancer, sufficient stomach observation time and thorough endoscopy education and training are essential to accurately identify the endoscopic features of Borrmann type IV gastric cancer." He added, "This study establishes quality indicator standards for gastroscopy in countries with a high risk of gastric cancer."

This study was published in the international journal in the field of gastroenterology, Clinical Gastroenterology and Hepatology (IF=13.576).

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