OBJECTIVETo investigate the feasibility of gastric cancer screening for the susceptible population in the high-risk areas of China and to optimize the screening programme.

METHODSBy using the two-round screening method i.e. serum pepsinogen test combined with gastric mucosa biopsy, large-scale population screening programs were carried out in Zhuanghe, Liaoning province. All adults or residents above 35 years old with a positive family history of gastric cancer or gastrointestinal symptoms were targeted.

RESULTSThree large-scale population screenings were developed over the past 15 years. All together, 13078 participants accepted the two-round screening, and 108 gastric cancer cases were detected. Among them, the detection rate of early gastric cancer was 56.82%, 51.22% and 82.61%, respectively. The pathologically confirmed gastric cancer cases were immediately arranged to have early surgical treatment, and meanwhile, the follow-up files for the patients were established. With a consecutive and regular 10-year postoperative follow-up, the 5-year survival rate for these early gastric cancer patients reached 90.48%. Effectiveness and health economic evaluation confirmed that there are good specificity and sensitivity for the two round screening programs. It is cost-effective. As the primary screening method serum PG test can improve the screening examination rate and concentrate the gastric cancer risk populations.

CONCLUSIONSIt is feasible to develop the gastric cancer screening program among the susceptible population in high-risk areas in our country, and the two-round screening method is of practical value. Research for early detection of gastric cancer should be further enhanced, and multidisciplinary and multicenter cooperation should be organized. It is necessary to extend the implementation the gastric cancer screening and to further improve the early detection programme, in order to make a breakthrough based on the present practice.