Gastric and esophageal cancer (GEC) belongs to the ten most frequent causes of cancer death worldwide. Detection and treatment of cancer at an early stage or its precursors using advanced endoscopic techniques would drastically decrease GEC incidence and mortality. However, the most precise definition of a high-risk group is key for cost-effective and ethically acceptable screening for GEC.
Thus, we will develop a two-step procedure. First, a risk score (RS) 1 based on self-reported risk factors will be established. In subjects with a high RS1, biomarkers predictive of cancer development will be analysed and the results integrated into a second RS. Only subjects at high risk (i.e. high RS 2) are eligible for endoscopic examination.
We will utilize data from the UK Biobank as a large existing cohort study and conduct a new validation study on premalignant lesions to develop and validate the first- and second-stage risk scores. Patients and potential screening participants will be involved in each step of the project. If successful, the risk-stratified screening approach will lead to a massive decrease in GEC incidence and mortality and thus will have a distinct public health impact on the (European) population.
