Overview
Unlike CRC screening (recommended for everyone), gastric cancer screening targets people at higher risk. In high-incidence countries (Japan, Korea), all adults undergo regular endoscopy. Saudi Arabia has moderate incidence — screening is targeted, not universal.
Symptoms
No symptoms of asymptomatic precancerous changes — the whole reason for screening
Symptomatic gastric cancer (late): persistent dyspepsia, weight loss, vomiting, anemia
Self-Care Tips
Eradicate H. pylori if positive.
Stop smoking.
Limit smoked, salted, pickled foods.
Increase fresh fruits and vegetables.
When to See a Doctor
Seek medical care promptly if you notice: Any of the symptomatic features above persisting >2 weeks, especially over 45.
Why it happens
Most gastric cancer in Saudi Arabia develops from chronic H. pylori infection through atrophic gastritis → intestinal metaplasia → dysplasia → cancer (Correa cascade). Other risks: family history, smoking, salty/smoked food, prior partial gastrectomy.
How common it is
Saudi gastric cancer rates are moderate — about 5-7 cases per 100,000. Higher in older adults and certain regions.
How it is diagnosed
Upper endoscopy with detailed inspection (often with narrow-band imaging) and biopsies. The Sydney protocol takes biopsies from 5 standard locations to identify atrophic gastritis and intestinal metaplasia.
Lifestyle and daily habits
Reduce risk; get screened if eligible.
• Eradicate H. pylori if positive.
• Stop smoking.
• Limit smoked, salted, pickled foods.
• Increase fresh fruits and vegetables.
Diet
Mediterranean diet is protective.
• Plant-rich, low in salt and processed meat.
Medicines
No specific medications for screening.
• H. pylori eradication for prevention.
Procedures and surgery
Targeted surveillance endoscopy.
• Surveillance endoscopy every 3 years for extensive intestinal metaplasia or atrophic gastritis.
• More frequent surveillance for high-grade dysplasia.
• Family history of gastric cancer in first-degree relative: discuss screening endoscopy.
Outlook
When intestinal metaplasia or dysplasia is found early, surveillance prevents progression to cancer. Early gastric cancer is curable by endoscopic resection (ESD) or surgery.
Questions to ask your doctor
• Am I at higher risk for gastric cancer?
• Should I have screening endoscopy?
• How often should I have surveillance?
Source and review
This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the SGA Patient Education Panel. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.
Frequently Asked Questions
What is Gastric Cancer Screening?
How is Gastric Cancer Screening diagnosed?
What is the outlook for Gastric Cancer Screening?
When should I see a doctor about Gastric Cancer Screening?
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