{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:41:50Z","timestamp":1790959310699,"version":"4.1.0"},"reference-count":50,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science and Technology Department of Sichuan Province, China","award":["23ZDYF0839"],"award-info":[{"award-number":["23ZDYF0839"]}]},{"name":"Ya\u2019an Science and Technology Plan of Economic and Social Development (Health Field), Ya\u2019an, China","award":["2024-1"],"award-info":[{"award-number":["2024-1"]}]},{"name":"Ya\u2019an Philosophic and Social Science Research Plan, Ya\u2019an, China","award":["YAA20240035"],"award-info":[{"award-number":["YAA20240035"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: In the absence of massive screening programs, it is imperative to develop and validate a candidate selection strategy for opportunistic endoscopic screening (OES) targeting the early detection of gastric cancer. Methods: A hospital-based cross-sectional study was conducted, enrolling both health check-up controls and gastric cancer patients. Data collection included two components: (1) a questionnaire including demography, self-reported comorbidities, and family history of cancers; (2) serology including hemoglobin, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9). Associations between potential variables and gastric cancer risk were assessed and the predictive efficacy of these risk factors was quantified. Sequentially, risk stratification scoring systems were constructed and their cost-effectiveness profiles were evaluated. Results: A total of 58,218 participants were included in the analysis, among whom 619 (1.1%) were gastric cancer patients. Multivariate analyses identified male, age &gt;40 years, family history of gastric cancer, comorbidities of upper digestive tract benign diseases (UDTBDs), anemia, and elevated serum CEA and\/or CA19-9 as independent risk factors of increasing gastric cancer risk. Cost-effectiveness analysis demonstrated that individuals, especially those symptomatic, presenting any of following conditions should be recommended for OES: (1) age \u226550 years, (2) family history of gastric cancer, and\/or (3) comorbid UDTBDs. Elsewise, unclear anemia and\/or elevated serum CEA and\/or CA19-9 presenting among males and\/or persons 41\u201350 years of age should be considered for OES. Notably, this selection strategy achieved a detection rate comparable to that of alternative protocols while yielding superior cost-effectiveness outcomes. Conclusions: The integrated strategy combining questionnaire and sequential serology represents an effective and cost-effective approach to identifying high-risk candidates for gastric cancer OES. Further investigations are warranted to develop more precise and tailored screening and surveillance protocols, with the aim of optimizing both detection rates and cost-effectiveness in clinical practice.<\/jats:p>","DOI":"10.3390\/jcm15010024","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:35:27Z","timestamp":1766392527000},"page":"24","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["An Opportunistic Screening Strategy for Gastric Cancer Based on Questionnaire and Sequential Serology: A Hospital-Based Cross-Sectional Study (SIGES)"],"prefix":"10.3390","volume":"15","author":[{"given":"Wen","family":"Xiang","sequence":"first","affiliation":[{"name":"Gastric Cancer Laboratory, Gastric Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Department of Thyroid and Breast Surgery, Chengdu Fifth People\u2019s Hospital (The Second Clinical Medical College, Affiliated Fifth People\u2019s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu 611137, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo-Yu","family":"Li","sequence":"additional","affiliation":[{"name":"Gastric Cancer Laboratory, Gastric Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Huang","sequence":"additional","affiliation":[{"name":"Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7619-6244","authenticated-orcid":false,"given":"Xin-Zu","family":"Chen","sequence":"additional","affiliation":[{"name":"Gastric Cancer Laboratory, Gastric Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Ya\u2019an Cancer Prevention and Control Center, Ya\u2019an People\u2019s Hospital\u2014West China Ya\u2019an Hospital, Sichuan University, Ya\u2019an 625000, China"},{"name":"Ya\u2019an Key Laboratory for High Altitude Medicine, Ya\u2019an People\u2019s Hospital\u2014West China Ya\u2019an Hospital, Sichuan University, Ya\u2019an 625000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1016\/S0140-6736(25)00052-2","article-title":"Gastric cancer","volume":"405","author":"Sundar","year":"2025","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1016\/S0140-6736(16)31967-5","article-title":"Improvement of cancer control in mainland China: Epidemiological profiles during the 2004\u201310 National Cancer Prevention and Control Program","volume":"388","author":"Chen","year":"2016","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/j.clinre.2014.04.014","article-title":"High mortality from hepatic, gastric and esophageal cancers in mainland China: 40 years of experience and development","volume":"38","author":"Wang","year":"2014","journal-title":"Clin. 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