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Endoscopic examination in the early diagnosis of high morbidity digestive cancer gastric and colon



Endoscopic examination in the early diagnosis of high morbidity digestive cancer gastric and colon



Revista de Medicina Interna Neurologie Psihiatrie Neurochirurgie Dermato-Venerologie Serie Medicina Interna 33(4): 319-329



The results obtained in the early diagnosis of high morbidity digestive cancer (gastric and colon), following the use of endoscopy (fibrogastroscopy and colonoscopy) and complementary methods (endobiopsy and controlled cytology), are analyzed. Endoscopy was applied after known screening tests in symptomatic populational groups without increased risks and in high risk symptomatic groups. Gastric cancer was diagnosed in 11 of 792 subjects in the 1st group, 1 of the 300 patients with Biermer's anemia or atrophic gastritis followed up for 2.2 yr, 18 of 239 patients with a gastric niche and 16 of 130 patients who underwent an operation for gastric or duodenal ulcer. No case of gastric cancer was found among the patients with gastric polyps. All of the 46 gastric cancers diagnosed exhibited endoscopic aspects of early cancer. After surgery, histologic examination of the operative specimen showed that only 9 of the 46 suffered from early gastric cancer (the muscularis propria was not exceeded and there were no lymph node or visceral metastases). Colonoscopy in 218 patients revealed 26 with cancer of the colon (12.7%), i.e., 8 cancers of the colon out of 134 symptomatic patients without lower digestive hemorrhage, 12 of 64 patients with lower digestive hemorrhage, 6 metachrone or recurrent cancers out of 30 operated cases of cancer of the colon, 1 out of 255 patients with ulcerohemorrhagic rectocolitis. Since mass detection of digestive cancer by endoscopic or other methods is not rewarding from the viewpoint of the cost/benefit ratio, a single methodology should be applied at least in the symptomatic population groups at or not at high risk. The benefit of early detection of digestive cancer among the asymptomatic population at risk still remains to be decided.

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