Early stomach cancer often asymptomatic; Taiwan expands screening program

Stomach cancer frequently lacks obvious early symptoms, causing many patients to seek medical attention only when experiencing issues like stomach pain, loss of appetite, weight loss, nausea, vomiting, or black stools. By then, the optimal window for treatment is often missed. To combat this, Taiwan's National Health Insurance has incorporated stomach cancer screening into its public health services. This initiative offers a free Helicobacter pylori stool antigen test to individuals aged 45 to 74, aiming to encourage early examination and treatment. Fengyuan Hospital recently treated two stomach cancer patients, highlighting the critical difference early detection makes. One 65-year-old man, who had no prior stomach pain or appetite issues, tested positive for H. pylori during a public screening. A subsequent gastroscopy revealed early-stage stomach cancer. He underwent radical surgery and, with pathological confirmation of early-stage cancer, required no chemotherapy, only regular follow-ups. In contrast, a 68-year-old man presented to the emergency room with nausea, vomiting, abdominal pain, and black stools. A gastroscopy confirmed stage three stomach cancer. He underwent radical surgery and is currently undergoing chemotherapy. Yuan Tian-min, Director of Surgery at Fengyuan Hospital, emphasized that while both patients have stomach cancer, their treatment paths and prognoses differ drastically due to the timing of diagnosis. "Stomach cancer in its early stages often has no obvious symptoms," Yuan stated. "The key factor truly affecting treatment outcomes is not the treatment method itself, but whether it can be diagnosed early." Early-stage stomach cancer offers a good prognosis through endoscopic resection or radical surgery, with some patients avoiding chemotherapy post-operation. However, stages three and four typically require a combination of surgery, chemotherapy, targeted therapy, or immunotherapy, leading to longer treatment durations and increased burdens. Yuan noted that the World Health Organization classifies H. pylori as a Group 1 carcinogen and a primary risk factor for stomach cancer, linked to 80-90% of cases. Japan's experience shows that promoting H. pylori testing and gastroscopy screening has increased early-stage stomach cancer detection from about 10% to 60%. With a cure rate exceeding 90% for early-stage cases, screening high-risk individuals can significantly improve treatment efficacy and overall survival rates. Yuan advised individuals with risk factors, such as a family history of stomach cancer, previous H. pylori infection, chronic gastritis, stomach ulcers, stomach polyps, long-term smoking, or frequent consumption of high-salt, pickled, or smoked foods, to seek medical evaluation. Persistent upper abdominal pain, indigestion, decreased appetite, unexplained weight loss, black stools, or anemia also warrant prompt medical examination.

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Stomach cancer in its early stages often has no obvious symptoms. The key factor truly affecting treatment outcomes is not the treatment method itself, but whether it can be diagnosed early.