“Advanced endoscopic techniques that were perfected and are commonly used in Japan are now being used increasingly around the world to detect and treat early gastric cancers.

During Monday’s ASGE Clinical Symposium Early Gastric Cancer in the West: Diagnosis and Management, three advanced endoscopists will discuss these techniques as well as the worldwide prevalence of gastric cancer and endoscopic treatment considerations.

Kenneth J. Chang, MD, FASGE, executive director of the Comprehensive Digestive Disease Center, professor and chief of gastroenterology and hepatology and the Anna and Vincent Kong endowed chair in endoscopic oncology at the University of California, Irvine, will co-moderate the symposium with Saowonee Ngamruengphong, MD, assistant professor at the Johns Hopkins University School of Medicine, Baltimore, MD.

“The prevalence of stomach cancer is very high in East Asia, Latin America, parts of Europe and the Middle East,” Dr. Chang said. “In the U.S., the incidence of gastric cancer has remained fairly modest, but there are ethnic subgroups in which the incidence is high.”

In the session’s first presentation, Andrew Y. Wang, MD, FASGE, associate professor of medicine and director of interventional endoscopy at the University of Virginia Medical Center, Charlottesville, will discuss who is at risk for gastric cancer and the role of screening, with a specific focus on intestinal metaplasia and atrophic gastritis.

“In Japan, it used to be that only about 15 percent of gastric cancers were early,” Dr. Chang explained. “Now, approximately 57 percent are early, which is mainly due to the introduction of screening programs. So, worldwide, there’s a growing emphasis on screening, early detection and endoscopic resection, which includes endoscopic mucosal resection and endoscopic submucosal dissection.”

In the next presentation, Susana Gonzalez, MD, of Gotham Medical Associates, New York, will review advanced imaging modalities for diagnosing early gastric cancer, specifically focusing on chromoendoscopy, endoscopic ultrasound and narrow-band imaging.

“In the U.S., we are seeing more and more of these early gastric cancers and we are beginning to identify and understand precancerous changes, such as intestinal metaplasia,” Dr. Chang said. “We’re able to apply new imaging modalities to look for precancerous cells in the stomach and then apply some of these traditionally Asian endoscopic techniques to resect them.”

In the final presentation, Joo Ha Hwang, MD, FASGE, associate professor at the University of Washington School of Medicine and chief of the gastroenterology section at Harborview Medical Center, Seattle, will discuss indications for endoscopy and when surgery is appropriate.
“It’s important for clinicians to know and understand the proper assessment and staging of a cancer to categorize them as early versus locally advanced,” Dr. Chang said. “This symposium will get people updated on which patients we should be screening, how to look for and manage precancerous changes, what endoscopic techniques are available for early gastric cancer, and when a lesion is beyond endoscopic treatment and should go to surgery.”

Please refer to the DDW Mobile App or the Program section in Monday’s DDW Daily News for additional details on this and other DDW^® events.