Effectiveness of Gastric Cancer Endoscopic Screening in Intermediate-Risk Countries: Protocol for a Systematic Review...

Area of Science:

• Gastroenterology
• Oncology
• Public Health

Background:

• Gastric cancer (GC) is a leading cause of cancer mortality globally, with significant geographical variations.
• Early detection of GC dramatically improves survival rates, yet screening recommendations vary, particularly in intermediate-risk (IR) regions.
• Upper endoscopy with biopsy is the established diagnostic standard for GC.

Purpose of the Study:

• To systematically review and determine the effectiveness of endoscopic screening for gastric cancer (GC) in intermediate-risk (IR) countries.
• To evaluate the efficacy, effectiveness, and cost-effectiveness of endoscopic GC screening in asymptomatic populations within IR countries.

Main Methods:

• A comprehensive search of multiple databases (MEDLINE, SCOPUS, Embase, Web of Science) and gray literature for relevant studies published until September 2024.
• Inclusion of randomized controlled trials, nonrandomized controlled trials, cohort studies, case-control studies, cross-sectional studies, and economic studies.
• Rigorous quality assessment using established tools (Cochrane risk of bias, ROBINS-I, Newcastle-Ottawa, NHLBI) and data categorization into efficacy/effectiveness and economic data for potential meta-analyses.

Main Results:

• The review is in the data extraction and risk of bias assessment phase, with 46 studies (44 from database search, 2 from manual search) retained for analysis.
• Results on efficacy, effectiveness, and cost-effectiveness of endoscopic screening in IR populations are anticipated.
• Publication of findings is expected in the first quarter of 2025.

Conclusions:

• This systematic review will be the first to provide evidence on the effectiveness of endoscopic GC screening specifically in intermediate-risk (IR) countries.
• Findings are expected to guide future research, inform healthcare policy, and support the implementation of GC screening programs in IR populations.