Update version of the Japanese Guidelines for Gastric Cancer Screening (Japanese Journal of Clinical Oncology, 2018)
Radiographic screening is recommended for population-based and
opportunistic screenings as its benefits outweigh its harms
(Recommendation Grade B). Endoscopic screening is also recommended for
population-based and opportunistic screenings as its benefits outweigh
its harms (Recommendation Grade B). Both screenings are recommended to
individuals aged 50 years and older.
These guidelines do not mention how often should the checkup be done, but another source recommends annual screening by gastroscopy only to people 70 years or older.
The optimal screening interval for gastric cancer using esophago-gastro-duodenoscopy in Japan (BMC Gastroenterology, 2012)
A screening for gastric cancer using esophago-gastro-duodenoscopy may
be appropriate annually for healthy people over 70 years old, every
two or three years for people 60–69 years old and every four years for
people 50–59 years old. People younger than 50 years old may only need
repeat screenings every five years or more.
BARIUM SWALLOW RADIATION EXPOSURE
Examples of radiation doses during various radiological investigations (See the table here: Mayo Clinic Proceedings, 2010):
- Barium swallow: 1.5 mSv (which equals 6 months of radiation exposure from natural background)
- Standard abdominal X-ray: 1.2 mSv
- CT of the abdomen and pelvis: 10 mSv
So, barium swallow results in only slightly greater radiation exposure than a standard abdominal X-ray. Most experts estimate the risk of the test like this (hps.org):
Fluoroscopic studies such as esophagrams and swallow studies are very
low-dose/low-risk procedures, where the little radiation exposure and
resultant absorbed dose do not result in any risk when compared to the
medical benefit of answering your physician's question concerning your
health.
GASTRIC CANCER RISK FACTORS
According to one systematic review, PubMed, 2018), main risk factors for gastric cancer include:
- Male sex, being East Asian, family history of gastric cancer
- Age (only 10% of all gastric cancers develops before 45 and most of them between 60-80 years of age)
- High consumption of salty or smoked food
- Smoking, excessive alcohol drinking, lack of physical activity
- Infection with H. pylori of the stomach, or Human papilloma virus
The frequency of tests for gastric cancer can be adjusted to risk factors in a particular person.