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Early gastric cancer: Epidemiology, clinical manifestations, diagnosis, and staging

Douglas Morgan, MD, MPH
Section Editors
Mark Feldman, MD, MACP, AGAF, FACG
Kenneth K Tanabe, MD
Deputy Editors
Kristen M Robson, MD, MBA, FACG
Diane MF Savarese, MD


Early gastric cancer (EGC) is defined as invasive gastric cancer that invades no more deeply than the submucosa, irrespective of lymph node metastasis (T1, any N). While EGC is of particular importance for patient care in Eastern Asia, its significance extends to other disciplines and patient populations:

Globally, gastric adenocarcinoma, with nearly one million incident cases annually, is the third leading cause of global cancer mortality and the leading cause of infection-associated cancer death [1-4]. EGC accounts for 15 to 57 percent of incident gastric cancer, depending upon the geographic region, and the presence of screening programs. (See 'Epidemiology' below.)

EGC has driven the development of novel imaging technologies for early neoplasia detection such as narrow band imaging and autofluorescence imaging. These technologies are now being used throughout the gastrointestinal tract.

The need for better approaches to the treatment of EGC has led to the development of advanced endoscopic resection techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection. (See "Early gastric cancer: Treatment, natural history, and prognosis", section on 'Endoscopic mucosal resection (EMR)' and "Early gastric cancer: Treatment, natural history, and prognosis", section on 'Endoscopic submucosal dissection'.)

New surveillance guidelines are in evolution for gastric premalignant lesions (eg, gastric intestinal metaplasia), which may increase the frequency of detection of EGC in low incidence populations [5,6]. (See "Gastric intestinal metaplasia" and "Gastric cancer screening".)

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Literature review current through: Nov 2017. | This topic last updated: Jan 26, 2017.
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