Duration of lead time in screening for gastric cancer Lead time of gastric cancer

Main Article Content

Jochanan Benbassat


Objective: Estimates of lead time (LT), i.e., from detection of cancer in asymptomatic persons to manifestations of the disease, can be obtained by follow-up of populations at risk, reviews of the past histories of patients with cancer, estimates of tumor doubling time, and from the ratio between the prevalence of cancer at the first round of screening and its annual incidence on subsequent screening rounds. Aim of this study is to derive the LT of gastric cancer (GC) from published studies.

Material and Methods: An overview of longitudinal studies and screening trials of GC; search of the reference sections of the retrieved papers for additional relevant studies; and calculation of the LT derived from these studies.

Results: LT was 2.8 – 7.3 years if derived from prospective follow-up studies; 1.0 - 4.0 years if derived from retrospective reviews of the patients' histories before the clinical diagnosis of GC; 5.9 - 8.6 years if derived from tumor doubling time; and 1.8 - 4.3 years if derived from prevalence / /incidence ratios.

Conclusions: There is wide variability in estimates of the LT of GC. Since an LT exceeding 6 six years may explain the improved survival of patients with screen-detected GS, the present survey does not obviate the need for randomized clinical trials of the effect of screening on gastric cancer mortality.


Download data is not yet available.

Article Details

How to Cite
Benbassat, J. (2021). Duration of lead time in screening for gastric cancer: Lead time of gastric cancer. Medical Science and Discovery, 8(10), 563–566. https://doi.org/10.36472/msd.v8i10.608
Review Article


Dong E, Duan L, Wu BU. Racial and Ethnic Minorities at Increased Risk for gastric cancer in a Regional US Population Study. Clinical Gastroenterology and Hepatology. 2017; 15: 511-517

Yang L, Zheng R, Wang N, Yuan Y, Liu S, Li H, Zhang S, Zeng H, Chen W. Incidence and mortality of stomach cancer in China, 2014. Chin J Cancer Res. 2018; 30: 291–298.

Hong S, Won YJ, Park YR, Jung KW, Kong HJ, Lee ES, and The Community of Population-Based Regional Cancer Registries, Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2017. Cancer Res Treat. 2020; 52: 335–350.

Suh YS, Lee J, Woo H, Shin D, Kong SH, Lee HJ, Shin A, Yang HK. National cancer screening program for gastric cancer in Korea: Nationwide treatment benefit and cost. Cancer. 2020; 126: 1929-1939

la Vecchia C, Negri E, D'Avanzo B, Franceschi S. Histamine-2 receptors antagonists and gastric cancer risk. Lancet 1990; 336: 335-57.

Bateman DN, Colin-Jones D, Hartz S, Langman M, Logan RF, Mant J, Murphy M, Paterson KR, Rowsell R, Thomas S, Vessey M. Mortality study of 18 000 patients treated with omeprazole. Gut. 2003; 52: 942–946

Poulsen AH, Christensen S, McLaughlin JK, Thomsen RW, Sørensen HT, Olsen JH, Friis S. Proton pump inhibitors and risk of gastric cancer: a population-based cohort study. British Journal of Cancer. 2009; 100: 1503 – 1507

Brusselaers N, Wahlin K, Engstrand L, Lagergren J. Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden. BMJ Open. 2017; 7: e017739.

Waldum HL, Gustafsson B, Fossmark R, Qvigstad G. Antiulcer Drugs and gastric cancer. Digestive Diseases and Sciences. 2005; 50 (Supplement 1): S39–S44.

Garcia Rodriguez LA, Lagergren J, Lindblad M (2006) Gastric acid suppression and risk of oesophageal and gastric adenocarcinoma: a nested case-control study in the UK. Gut. 55: 1538–1544

Correa P. Gastric cancer: Overview. Gastroenterol Clin North Am. 2013; 42: 211–217.

Altayar O, Davitkov P, Shah SC, Gawron AJ, Morgan D, Turner K, Mustafa RA. AGA Institute Technical Review on Gastric Intestinal Metaplasia – Epidemiology and Risk Factors Gastroenterology. 2020; 158: 732–744

De Vries AC, van Grieken NC, Looman CWN, Casparie MK, De Vries E, Meijer GA, Kuipers EJ. Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands. Gastroenterology. 2008; 134: 945-52.

Li D, Bautista MC, Jiang SF, Daryani P, Brackett M, Armstrong MA, Hung YY, Postlethwaite D, Ladabaum U. Risks and Predictors of Gastric Adenocarcinoma in Patients with Gastric Intestinal Metaplasia and Dysplasia: A Population-Based Study. Am J Gastroenterol. 2016; 111: 1104-1113

Dhingra R, Natov NS, Daaboul Y, Guelrud M, Cherukara A, Hung PF, Sterling MJ. Increased Risk of Progression to Gastric Adenocarcinoma in Patients with Non‑dysplastic Gastric Intestinal Metaplasia Versus a Control Population Digestive Diseases and Sciences. 2020; 65: 3316–3323

Kong SH, Park DJ, Lee HJ, et al, Clinicopathologic features of asymptomatic gastric adenocarcinoma patients in Korea. Jpn J Clin Oncol. 2004; 34: 1–7.

Guanrei Y, Songliang Q, He H, Guizen F. Natural history of early esophageal squamous carcinoma and early adenocarcinoma of the gastric cardia in the People's Republic of China. Endoscopy. 1988; 20: 95-8

Tsukuma H, Oshima A, Narahara H, Morii T. Natural history of early gastric cancer: a non-concurrent, long term, follow up study. Gut. 2000; 47: 618-21

Oh SY, Lee JH, Lee HJ, Kim TH, Huh YJ, Ahn HS, Suh YS, Kong SH, Kim GH, Ahn SJ, Kim SH, Choi Y, Yang HK. Natural History of GC: Observational Study of Gastric Cancer Patients Not Treated During Follow-Up. Ann Surg Oncol. 2019; 26: 2905-2911

Koizumi S, Kida M, Yamauchi H, Okuwaki K, Iwai T, Miyazawa S, Takezawa M, Imaizumi H, Koizumi W. Clinical implications of doubling time of gastrointestinal submucosal tumors. World J Gastroenterol. 2016; 22: 10015-10023

Saito H, Osaki T, Murakami D, Sakamoto T, Kanaji S, Oro S, Tatebe S, Tsujitani S, Ikeguchi M. Macroscopic tumor size as a simple prognostic indicator in patients with gastric cancer. The American Journal of Surgery. 2006; 192: 296–300

Li C, Oh SJ, Kim S, Hyung WJ, Yan M, Zhu ZG, Noh SH. Risk Factors of Survival and Surgical Treatment for Advanced gastric cancer with Large Tumor Size. J Gastrointest Surg. 2009; 13: 881.

Henschke, C.I., Salvatore, M., Cham, M. Powell CA, DiFabrizio L, Flores R, Kaufman A, Eber C, Yip R, Yankelevitz DF. Baseline and annual repeat rounds of screening: implications for optimal regimens of screening. Eur Radiol. 2018; 28: 1085–1094.

Shiratori Y, Nakagawa S, Kikuchi A, Ishii M, Ueno M, Miyashita T, Sakurai T, Negami J, Suzuki T, Sato I. Significance of a Gastric Mass Screening Survey. American Journal of Gastroenterology. 1985; 80: 831-834

Hamashima C, Okamoto M, Shabana M, Osaki Y, Kishimoto T. Sensitivity of endoscopic screening for GC by the incidence method. Int. J. Cancer. 2013; 133; 653–660.

Matsumoto S, Yamasaki K, Tsuji K, Shirahama S. Results of mass endoscopic examination for gastric cancer in Kamigoto Hospital, Nagasaki Prefecture. World J Gastroenterol. 2007; 13: 4316-4320

Portnoi LM, Kazantseva IA, Isakov VA, Nefedova VI, Gaganov LE. GC screening in selected population of Moscow region: retrospective evaluation Eur Radiol. 1999; 9: 701-705

Bae JM, Shin SY, Kim EH. Optimal Interval for Repeated GC Screening in Normal-Risk Healthy Korean Adults: A Retrospective Cohort Study. Cancer Res Treat. 2015; 47: 564-568

Kim H, Hwang Y, Sung H, Jang J, Ahn C, Kim SG, Yoo KY, Park SK. Effectiveness of GC Screening on GC Incidence and Mortality in a Community-Based Prospective Cohort. Cancer Res Treat. 2018; 50: 582-589

Everett SM, Axon ATR. Early gastric cancer: disease or pseudo-disease? THE LANCET, 1998; 351: 1350-3