Gastric cancer diagnosis: biomarker assessment

Graham Johnson introduces the first non-invasive test for assessing the structure and function of the stomach in patients presenting with dyspepsia.

This serological biomarker assay can be used in the primary care setting and also in secondary care as a pre-endoscopy assessment tool to ensure appropriate referral.

Dyspepsia is a common health issue in the UK, affecting 20–40% of the population.1 It is generally well managed by GPs in primary care, but in refractory cases or when patients present with more urgent symptoms it may indicate something potentially more sinister. Dyspepsia can signal diseases in the gastrointestinal (GI) tract, including atrophic gastritis (AG) or gastric intestinal metaplasia (GIM), both of which are significant risk factors for gastric cancer 

Atrophic gastritis can be caused by a persistent Helicobacter pylori infection in the gastric mucosa or by autoimmune mechanisms, and 18% of cases progress to cancer within 10 years.2 H. pylori is a class 1 (carcinogenic) pathogen and dyspeptic patients can be tested for the bacterium in primary care under current patient care pathways. For some patients with new onset of dyspepsia or alarm symptoms, referral for endoscopy is common, which is invasive and a huge cost burden to the healthcare system.

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