Gastric Cancer Screening
Endoscopy screening is recommended for high-risk groups — family history of gastric cancer, prior H. pylori with intestinal metaplasia, or specific ethnic backgrounds. NOT routine for average-risk Saudis.
Category
Screening
Red flags
1
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
Unlike CRC screening (recommended for everyone), gastric cancer screening targets people at higher risk. In high-incidence countries (Japan, Korea), all adults undergo regular endoscopy. Saudi Arabia has moderate incidence — screening is targeted, not universal.
How common is it?
Saudi gastric cancer rates are moderate — about 5-7 cases per 100,000. Higher in older adults and certain regions.
Why does it happen?
Most gastric cancer in Saudi Arabia develops from chronic H. pylori infection through atrophic gastritis → intestinal metaplasia → dysplasia → cancer (Correa cascade). Other risks: family history, smoking, salty/smoked food, prior partial gastrectomy.
Symptoms
- No symptoms of asymptomatic precancerous changes — the whole reason for screening
- Symptomatic gastric cancer (late): persistent dyspepsia, weight loss, vomiting, anemia
Red flags — seek urgent medical care
Any of the symptomatic features above persisting >2 weeks, especially over 45
Endoscopy needed promptly.
How is it diagnosed?
Upper endoscopy with detailed inspection (often with narrow-band imaging) and biopsies. The Sydney protocol takes biopsies from 5 standard locations to identify atrophic gastritis and intestinal metaplasia.
Outlook — what to expect
When intestinal metaplasia or dysplasia is found early, surveillance prevents progression to cancer. Early gastric cancer is curable by endoscopic resection (ESD) or surgery.
Treatment
Habits & Lifestyle
Reduce risk; get screened if eligible.
- Eradicate H. pylori if positive.
- Stop smoking.
- Limit smoked, salted, pickled foods.
- Increase fresh fruits and vegetables.
Diet
Mediterranean diet is protective.
- Plant-rich, low in salt and processed meat.
Medications
No specific medications for screening.
- H. pylori eradication for prevention.
Procedures & Surgery
Targeted surveillance endoscopy.
- Surveillance endoscopy every 3 years for extensive intestinal metaplasia or atrophic gastritis.
- More frequent surveillance for high-grade dysplasia.
- Family history of gastric cancer in first-degree relative: discuss screening endoscopy.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Am I at higher risk for gastric cancer?
- Should I have screening endoscopy?
- How often should I have surveillance?
Medically reviewed by: SGA Patient Education Panel · Last reviewed 24/04/2026