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    Published on 10 March 2024

    Discover the breakthrough of GASTROClear blood test, offering precise risk assessment and staging for gastric cancer, transforming early diagnosis prospects.

    Gastric cancer, also known as stomach cancer, lurks silently within the digestive system. It occurs when healthy cells in the stomach lining mutate and multiply uncontrollably, forming tumours that disrupt the proper functioning of the organ.

    According to data from the  National University Cancer Institute Singapore (NCIS), this form of cancer is the fourth most common cause of cancer deaths in men and fifth most common in women. In Singapore alone, it results in the loss of 300 to 500 lives every year.

    A gamechanger in gastric cancer detection

    Existing diagnostic procedures for gastric cancer include endoscopies, biopsies and CT scans. However, these have limitations. Endoscopies can be invasive and uncomfortable, while biopsies carry risks of bleeding and infection.

    Additionally, they may not always detect early-stage tumours, which are often asymptomatic. This often leads to gastric cancer going undiagnosed until it hits advanced stages, resulting in a higher mortality rate.

    Recognising these shortcomings, researchers from the  National University Health System (NUHS) have developed a novel test for the cancer called GASTROClear. The goal? More successful treatments and cures thanks to early detection.

    Here are five things to know about this test:

    1. It’s the first blood test method for detecting gastric cancer globally

      While cancer marker blood tests exist for certain cancers like pancreatic, ovarian and liver cancer, GASTROClear is a first-of-its-kind designed to detect gastric cancer. Patients whose blood test is positive can then go for follow-up procedures such as an endoscopy to get a further assessment.  

    2. It is cost-effective and less invasive than traditional methods

      An endoscopy — which is the standard method for detecting gastric cancer — involves inserting a thin tube with a light, tiny camera through the mouth and down the oesophagus into the stomach to examine the upper digestive tract. This can be a physically uncomfortable process.

      GASTROClear helps patients avoid an endoscopy if they are found not to be at risk after undergoing the blood test. Furthermore, the procedure is more cost-effective than an endoscopy or biopsy.

      1. It allows patients to seek treatment early and have a higher chance of survival
      2. According to Prof Jimmy So, the Head of the Division of Surgical Oncology at NCIS, about 60 per cent of patients with gastric cancer in Singapore are only diagnosed when the cancer has progressed to an advanced stage. The Senior Consultant added that when discovered at a late stage, there is a “less than 10 per cent chance of survival”.

        Notable symptoms of gastric cancer are often absent until the cancer has reached a more advanced stage. Some of these symptoms like persistent indigestion or upper abdominal pain could be mistaken for less serious conditions, which means a person is less likely to think about getting tested for gastric cancer.

        With GASTROClear, a person detected to be at high risk of developing gastric cancer or a family history of it can get tested early, allowing them to immediately manage their risk factors or seek treatment as soon as possible.

        1. It can identify different stages of gastric cancer in patients
        2. GASTROClear works by measuring the levels of microRNA, a genetic material produced by cells, including cancer cells, in the blood.

          Prof So and his team scrutinised over 600 microRNA, which are known to be elevated in people with cancers and identified a group of microRNA specific to gastric cancer. They discovered 12 specific microRNA that tell them which stage of gastric cancer a person has, making it possible to identify these markers with a blood test.

          1. It is approved for use in local hospitals and polyclinics
          2. If you or your loved ones are at-risk, you’ll be able to get pre-screened for gastric cancer at public hospitals such as  National University Hospital (NUH)National University Polyclinics (NUP), some private general practitioner clinics and specialist clinics. 

            “Oftentimes, many patients do not want to come forward for tests despite being advised to by their doctors. We hope that by using blood tests like GASTROClear, many patients can come forward for screening for their gastric problems,” says Prof So, who hopes that it will become one of the standard screening methods for gastric cancer.

          In consultation with  Prof Jimmy So, Head & Senior Consultant, Division of General Surgery (Upper Gastrointestinal Surgery), Department of Surgery,  NUH; Head & Senior Consultant, Division of Surgical Oncology,  NCIS; Professor,  Yong Loo Lin School of Medicine, National University of Singapore; and Associate Director,  NCIS.

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