Introducing Chromoscopy in Endoscopic Screening for Gastric Cancer in Kazakhstan

The advancement of gastric cancer screening methodology based on endoscopic gastrointestinal tract examination is a pertinent global issue. This approach is designed to identify precancerous lesions and early-stage cancers. The aim was to integrate chromoscopy into endoscopic screening for early gastric cancer diagnostics.

The study involved 3062 residents of the Republic of Kazakhstan with a history of complaints or various diseases of the digestive organs. This cohort underwent endoscopic examinations using the chromoscopy method with further morphologic studies of the biopsy specimen obtained during endoscopic examination, according to the results of which the gastric cancer risk groups were formed.

As a result of gastric endoscopy of 2976 patients without a previously established diagnosis of gastric cancer using the chromoscopy method, the following were found: inflammatory diseases of the stomach-72.9%, gastric ulcerative lesions-9.5%, gastric submucosal masses-1.1%, polypous gastric mass on a thin peduncle-0.83%, polypous gastric mass on a broad peduncle-4%, pathomorphologically verified gastric mesenchymal neoplasms under 3 cm in size-1.4%, over 3 cm-7.4% (including 0.8% with oesophageal cancer with spread to the stomach), cancer of the lower third of the oesophagus-1.53% of cases. The stomach was without pathology only in 0.4% of cases. The analysis of chromoendoscopy results of 86 people with previously diagnosed gastric cancer ("dynamic" group) showed that 94.19% of patients showed positive dynamics after treatment, in 3.49% of cases no dynamics was observed, in 2.32% of cases-negative dynamics.

Considering the findings of this study, it is recommended that chromoscopy be included in the algorithm for the screening of early gastric cancer and for the dynamic follow-up of patients undergoing treatment.