{"entity":{"id":"idea-prev-gastric-serology-migrant-screening","kind":"idea","name":"Stomach cancer serology screening for high-risk migrant communities in low-incidence countries","aka":[],"tldr":"People who grew up in East Asia, Eastern Europe or Latin America keep a high stomach cancer risk after migrating. Cheap blood tests could select who needs an endoscopy.","summary":"Pepsinogen I/II ratio plus H. pylori serology (the ABC method) stratifies gastric cancer risk in Japan. Western countries do not screen because average incidence is low, but first-generation migrants from high-incidence regions carry two- to five-fold risk. Propose targeted serological screening with endoscopy for high-risk groups.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (The hardest cancers are found late): Crosby et al., Early detection of cancer (Science 2022)","url":"https://doi.org/10.1126/science.aay9040"}],"tags":[],"related":[],"cancers":["gastric"],"sections":["early-detection"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-early-detection","b-trial-diversity"],"keyPapers":["paper-crosby-science"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Serology-directed endoscopy in first-generation migrants from high-incidence regions aged 50 and over yields early gastric cancer or high-grade dysplasia in at least 1% of endoscopies, comparable to Japanese and Korean programmes.","rationale":"Risk follows birthplace and childhood H. pylori acquisition; the serology is cheap and validated.","test":"Pilot in 5,000 participants in a large migrant community (e.g. California, London); yield and cost per early cancer.","maturity":"speculative","actor":"clinic","cost":"small","horizonYears":4},"route":"/ideas/idea-prev-gastric-serology-migrant-screening/","neighbours":{"cancer":[{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"}],"bottleneck":[{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"},{"id":"b-trial-diversity","kind":"bottleneck","name":"Trials do not represent the people who get cancer","route":"/bottlenecks/b-trial-diversity/"}],"paper":[{"id":"paper-crosby-science","kind":"paper","name":"Early detection of cancer","route":"/key-papers/paper-crosby-science/"}]}}