MARK's Quadrant scoring system: a symptom-based targeted screening tool for gastric cancer

Area of Science:

• Gastroenterology
• Oncology
• Medical Diagnostics

Background:

• Gastric cancer is a leading cause of cancer death globally.
• Late-stage presentation in Malaysia limits treatment options and curable resection.
• Delayed diagnosis due to failure in identifying high-risk patients and endoscopic procedures.

Purpose of the Study:

• To develop and validate the MARK's Quadrant scoring system.
• To identify symptomatic patients at risk for gastric cancer.
• To improve early detection rates in a low-incidence region.

Main Methods:

• A 3-phase approach was used for development and validation.
• Phase 1: Weighted scoring system development.
• Phase 2 & 3: Assessing positive predictive value, validity in an open-access system, and comparison to conventional referral.

Main Results:

• MARK's Quadrant demonstrated 88% sensitivity and 45.5% specificity for gastric lesions.
• Diagnostic yield for any pathological lesion was 95.2% in Phase 3.
• The system showed significant odds ratios for diagnosing cancer and precancerous lesions compared to routine referral.

Conclusions:

• MARK's Quadrant is an effective tool for detecting early gastric cancer in symptomatic individuals.
• The scoring system aids in identifying patients requiring timely endoscopic evaluation.
• It offers improved diagnostic accuracy in regions with lower gastric cancer incidence.