[Coverage of diagnostic upper gastrointestinal endoscopy for the prevention of gastric cancer in Chile: results from the 2009-2010 National Health Survey]

Rev Med Chil. 2015 Sep;143(9):1198-205. doi: 10.4067/S0034-98872015000900014.
[Article in Spanish]

Abstract

Background: In Chile, gastric cancer (GC) is a major cause of cancer related deaths. The current screening strategy consists of an upper gastrointestinal endoscopy (UGE) for people aged 40 years or more with epigastric pain.

Aim: To evaluate the diagnostic coverage of the use of UGE for early detection of GC in Chile.

Material and methods: As part of the digestive module of the 2009-10 National Health Survey, 5293 adults over 15 years were asked about the presence of epigastric pain, possible upper gastrointestinal bleeding (PUGB), use of proton pump inhibitors (PPIs) or histamine H2-receptor antagonists (H2RAs), family history of GC and having performed an UGE.

Results: Persistent epigastric pain was observed in 3.4% of the population. PUGB signs were observed in 3.3% of the population. The prevalence of PPIs and H2RAs use was 4.3% and 2.2% respectively, reaching 21.6% in people aged 70 years and older. Life span prevalence of UGE was 18.3%, with differences by region, health insurance and educational level. UGE coverage in people aged 40 years or older with and without persistent epigastric pain was 14.4% and 3.2% respectively (Odds ratio 4.8, p < 0.01). The prevalence of UGE was similar among people with or without PUGB or family history of CG.

Conclusions: The estimated coverage of the current GC prevention strategy in Chile is 14.4%, evaluated at a population level. Further studies are required to determine the impact of this strategy on early GC diagnosis and mortality.

Publication types

  • English Abstract

MeSH terms

  • Abdominal Pain / drug therapy
  • Abdominal Pain / epidemiology
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Chile / epidemiology
  • Educational Status
  • Endoscopy, Gastrointestinal / methods
  • Endoscopy, Gastrointestinal / statistics & numerical data*
  • Female
  • Gastrointestinal Hemorrhage / drug therapy
  • Gastrointestinal Hemorrhage / epidemiology
  • Health Surveys / statistics & numerical data*
  • Histamine H2 Antagonists / therapeutic use
  • Humans
  • Male
  • Mass Screening / methods
  • Mass Screening / statistics & numerical data*
  • Multivariate Analysis
  • Prevalence
  • Proton Pump Inhibitors / therapeutic use
  • Residence Characteristics / statistics & numerical data
  • Sex Distribution
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / prevention & control*

Substances

  • Histamine H2 Antagonists
  • Proton Pump Inhibitors