Screening would be helpful for finding early tumors that do not reach the outer wall of the stomach (serosa) or penetrate the serosa but have not spread to lymph nodes . By looking at the stomach through a lighted tube (fiberoptic endoscopy) or by using x-rays of the upper gastrointestinal tract, smaller tumors can be detected. These tests are especially pertinent for people with gastric complaints.
Although screening programs are available in countries such as Japan with high gastric cancer rates, they are not common in North America. Screening is not cost-effective, given the dramatic decline in the incidence of stomach cancer. Upper gastrointestinal x-rays, for example, discover cancer in only 0.15 percent (1 in 600) of apparently healthy people.
