Screening strategies for the early detection of non-cardia gastric cancer in low- to moderate-prevalence regions: Asia-Pacific gastroesophageal cancer congress consensus 2026 - Report - MDSpire
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Early Detection of Non-Cardia Gastric Cancer in Low- to Moderate-Prevalence Areas: 2026 Asia-Pacific Gastroesophageal Cancer Congress Consensus on Screening Strategies

  • By

  • Ayaka Takasu

  • Fumiaki Ishibashi

  • Rapat Pittayanon

  • Hon Chi Yip

  • James Weiquan Li

  • Munkhsaruul Bayaraa

  • Hyunsoo Chung

  • Do Hoon Kim

  • Kamin Harinwan

  • Quang Dinh Le

  • Adolfo Parra-Blanco

  • Paulo Kassab

  • Vincenzo Giorgio Mirante

  • José Murillo-Rodriguez

  • Regina Rie Imada

  • Renata Nobre Moura

  • Sabina Beg

  • Pedro Genaro Delgado-Guillena

  • Marta Rodriguez-Carrasco

  • Seung-Hun Chon

  • Chul S. Hyun

  • Grigorios Christodoulidis

  • Vo Duy Long

  • Zili Xiao

  • Sergey Kashin

  • Roman Kuvaev

  • Ian Yu-Hong Wong

  • Robert Bechara

  • Mitsuru Esaki

  • Waku Hatta

  • Motohiko Kato

  • Seiichiro Abe

  • Sho Suzuki

  • Kohei Takizawa

  • Joo Ha Hwang

  • Wai Keung Leung

  • Duc Trong Quach

  • Matsuda Satoru

  • Han-Kwang Yang

  • Takuji Gotoda

  • October 14, 2026

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Clinical Report: Early Detection of Non-Cardia Gastric Cancer in Low- to Moderate-Prevalence Areas

Overview

A 2026 Asia-Pacific Gastroesophageal Cancer Congress consensus initiative addressed screening strategies for non-cardia gastric cancer in regions with a combined-sex age-standardized incidence rate below 20 per 100,000 person-years. The report describes a modified Delphi process involving 37 international experts and 11 clinical questions, but the supplied article excerpt does not include the resulting recommendations.

Background

Gastric cancer is the fifth leading cause of cancer-related mortality worldwide, and Helicobacter pylori is identified as its principal etiological factor. Screening has been an important public health strategy in regions with high H. pylori prevalence and gastric cancer burden. Improved sanitation and living conditions have reduced H. pylori infection, while population diversity means that individuals from high-prevalence areas may live in regions with lower overall incidence. The consensus focused on non-cardia gastric cancer and sought to address uncertainty about screening in low- to moderate-prevalence settings.

Data Highlights

ItemDetails reported
Consensus processModified Delphi process using GRADE principles and predefined modifications
Participants and questions37 international experts assessed 11 clinical questions
MeetingMarch 2026, alongside the 11th Asia Pacific Gastroesophageal Cancer Congress in Japan
Regional classificationHigh risk: ASR ≥20; intermediate risk: ASR 10–19.9; low risk: ASR <10 per 100,000 person-years
Consensus scopeCombined male and female gastric cancer ASR <20 per 100,000 person-years; high-risk regions were excluded
Evidence reviewFor each clinical question, two authors separately searched English-language MEDLINE publications and assessed evidence certainty using GRADE

Key Findings

  • The consensus defined low- to moderate-prevalence regions operationally as areas with a combined-sex gastric cancer ASR below 20 per 100,000 person-years, using GLOBOCAN 2022 estimates.
  • Japan, the Republic of Korea, Mongolia, and parts of China were outside the consensus scope because they met the stated high-risk threshold.
  • The working group formulated 11 clinical questions using the PICO framework; assigned authors reviewed evidence and drafted recommendations with explanatory notes.
  • The literature review used structured searches of English-language MEDLINE publications, with evidence certainty evaluated using GRADE.
  • The meeting emphasized early detection of non-cardia gastric cancer rather than gastric cardia or gastroesophageal junction cancer.
  • Related guidance summarized in the supplied web research describes differing approaches by incidence: MAPS III advises against population-based endoscopic screening in low-incidence regions and conditions screening in intermediate-risk regions on demonstrated cost-effectiveness; the 2025 ACG guideline suggests against routine EGD screening in the general U.S. population.

Clinical Implications

The supplied excerpt establishes the consensus scope and methods but does not provide its final recommendations, so specific screening intervals or eligibility criteria cannot be attributed to this consensus from the available material. The related guidance provided distinguishes screening approaches by regional incidence and describes risk assessment and surveillance for selected people with gastric premalignant conditions.

Conclusion

The 2026 APGCC consensus was designed to standardize consideration of non-cardia gastric cancer screening in low- to moderate-prevalence regions through an international, evidence-review-based Delphi process. Its specific recommendations are not included in the supplied excerpt.

Related Resources & Content

  1. 2025 ESGE/EHMSG/ESP, Endoscopy, 2025 — MAPS III guideline
  2. American College of Gastroenterology, American Journal of Gastroenterology, 2025 — Clinical Guideline: Diagnosis and Management of Gastric Premalignant Conditions
  3. National Cancer Institute, n.d. — Screening for Stomach Cancer
  4. Eradication Therapy to Prevent Gastric Cancer in Helicobacter pylori-Positive Individuals: Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies, PubMed, 2025
  5. ASCO Publications, 2015 — Gastric cancer prevention and early detection program for an at-risk population: A prospective study of the Korean American community
  6. ASCO Publications, 2020 — Screening and treatment strategy for double cancer for esophageal cancer surgery patients
  7. The New Gastroenterologist, 2025 — Proactively Addressing Gastrointestinal Cancers in Younger Populations
  8. ASCO Publications — A pilot case control study: Could a gastric cancer risk screening tool help identify high risk patients for endoscopic screening in the United States?
  9. MAPS III guideline
  10. 2025 ACG Clinical Guideline: Diagnosis and Management of Gastric Premalignant Conditions
  11. Screening for Stomach Cancer - NCI
  12. Eradication Therapy to Prevent Gastric Cancer in Helicobacter pylori-Positive Individuals: Systematic Review and Meta-Analysis
  13. Helicobacter pylori Screen-and-Treat Programs for Gastric Cancer Prevention — IARC Working Group Report | New England Journal of Medicine
  14. Advancing Gastric Cancer Prevention in Korea: Current Strategies and Future Directions - Park - 2026 - Helicobacter - Wiley Online Library
  15. Asian Pacific Association of Gastroenterology task force recommendations on surveillance for Helicobacter pylori associated gastric premalignant conditions

Original Source(s)

Screening strategies for the early detection of non-cardia gastric cancer in low- to moderate-prevalence regions: Asia-Pacific gastroesophageal cancer congress consensus 2026

  • by Ayaka Takasu, Fumiaki Ishibashi, Rapat Pittayanon, Hon Chi Yip, James Weiquan Li, Munkhsaruul Bayaraa, Hyunsoo Chung, Do Hoon Kim, Kamin Harinwan, Quang Dinh Le, Adolfo Parra-Blanco, Paulo Kassab, Vincenzo Giorgio Mirante, José Murillo-Rodriguez, Regina Rie Imada, Renata Nobre Moura, Sabina Beg, Pedro Genaro Delgado-Guillena, Marta Rodriguez-Carrasco, Seung-Hun Chon, Chul S. Hyun, Grigorios Christodoulidis, Vo Duy Long, Zili Xiao, Sergey Kashin, Roman Kuvaev, Ian Yu-Hong Wong, Robert Bechara, Mitsuru Esaki, Waku Hatta, Motohiko Kato, Seiichiro Abe, Sho Suzuki, Kohei Takizawa, Joo Ha Hwang, Wai Keung Leung, Duc Trong Quach, Matsuda Satoru, Han-Kwang Yang, Takuji Gotoda

  • October 14, 2026

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