Gastrointestinal cancer screening and surveillance programmes : a worldwide perspective : part 1

Abstract

Cancer is a leading cause of death worldwide and such deaths are projected to continue to rise, creating significant morbidity and mortality. Devising programmes to detect early cancer, aiming to achieve complete cure, has been high on the agenda of various professional bodies. This paper focuses on the various screening and surveillance programmes around the world, aiming at detecting early gastrointestinal malignancies. Starting with Barretts’ oesophagus, we shall see the different surveillance programmes across countries to detect premalignant stages of oesophageal cancer, while at the same time reviewing the only country in the world, China, which has an oesophageal cancer mass screening programme. Moving to gastric cancer, we shall review Japan’s screening programme, followed by other countries’ measures in surveilling premalignant gastric conditions. Colorectal cancer is the only gastrointestinal cancer where mass screening has been employed in various countries. This will be discussed in detail, with particular emphasis on the British and American systems. We shall also be discussing the surveillance programmes for moderate and high risk patients of colorectal cancer. Finally, we shall also review the different recommendations with regards to screening for hepatocellular carcinoma.