Initial screening for high-risk population of gastric cancer (GC) is needed in rural areas of large-population countries.

This is a prospective study with ~15,000 asymptomatic residents from 24 rural villages in Changxing Island, Shanghai, China.

We evaluated the performance of oral contrast-enhanced trans-abdominal ultrasonography (OCTU) in screening high-risk GC.

OCTU could serve as an effective initial screening method of GC or supplement to the current risk stratification rule.

Initial screening for high-risk population of gastric cancer (GC) is needed in rural areas of large-population countries. This study aims to explore the feasibility of applying noninvasive ultrasonography as an initial screening strategy to improve the early diagnosis and prevention of GC.

Oral contrast-enhanced trans-abdominal ultrasonography (OCTU) was initially applied to screen around 15,000 residents from 24 different rural villages of Changxing Island in Shanghai, China, facilitating the identification of high-risk population for further endoscopy examination.

176 subjects (1.18 %) were initially identified with gastric diseases using OCTU while 14,787 ones (98.93 %) were normal with negative results. 145 out of 176 individuals (82.39 %) took further endoscopy examination, and 16 were diagnosed with GC with biopsy examination, with 9 of them at the early stage. We followed up with the Center for Disease Control and Prevention, and identified another 6 GC cases occurred within one year among OCTU-negative population, serving as an adjustment factor for sensitivity analysis. As a result, with a total of 22 GC cases included in this cohort, the positive predictive rate, the negative predictive value, sensitivity, and specificity were 9.09％, 99.96 %, 75.5 %, and 98.93 %, respectively.

OCTU is feasible, non-invasive, low-cost, and widely acceptable in rural area, thus we proposed that OCTU is practicable to serve as a supplementary screening method to improve the early detection of GC in rural area of China and other developing countries with large population.

Gastric cancer

Ultrasonography

Initial screening

High risk

Rural area

Oral contrast-enhanced trans-abdominal ultrasonography

Positive predictive value

Negative predictive value

© 2022 Published by Elsevier Ltd.