[Early gastric cancer: main objective in a mass screening program for gastric cancer]

In Táchira's State, Venezuela, there is a high incidence of Gastric Cancer. Screening for early gastric cancer (EGC) detection began in 1981. It observes the Japanese model, with Indirect Radiological (IR) as the move to the various Municipalities, offering the screening test. Subjects with IR abnormalities receive an invitation for an endoscopic examination. If lesions at endoscopy, biopsies were taken. Treatable patients went to surgery; the diagnosis on the surgical specimen was fulfilled by trained Pathologists. CGs cases are actively followed up. From 1981 to 1992 we did 150.023 radiological studies 52.562 gastric endoscopies and 18,480 endoscopic biopsies. We diagnosed 612 CGs:450 were advanced: 102 patients with 113 EGCs with confirmation after surgery; 60 cases were suspected by radiology and endoscopy as EGCs but were nor confirmed because the patients were not operated. 89 patients underwent gastroectomies, and 13 endoscopy resections. The EGCs were depressed (Types IIc, III) in 49% elevated (Types I, IIa) 26%, flat (Type IIb) 6% and intermediate (Types IIa + IIc) 19%. The invasion was confined to the mucosa in 60% and to the submucosa in 40%. By histopathology 60% were differentiated and 40% undifferentiated. In 9% we found metastasis in lymph nodes, only in 2% of the mucosal ones. Survival of patients with EGC after 5 year was 93%. We think a secondary prevention can be done in high risk regions through an appropriate screening for EGC.