Screening for gastrointestinal cancer is shifting from early detection to identifying pre-disease conditions

Abstract

According to Cancer Statistics 2024¹, the projected number of cancer-related deaths in 2023 was approximately 395,000, nearing 400,000. Based on the demographic statistics released in June 2024 (for June 2024)², pancreatic cancer overtook stomach cancer in Japan’s confirmed 2023 total death toll, becoming the third leading cause of cancer deaths. This indicates the continued difficulty in detecting “early-stage” pancreatic cancer that offers the potential for long-term survival, even with advanced imaging techniques.

This underscores the urgent need to develop and implement new cancer screening methods. Incorporating AI into morphological diagnostics, and considering diagnostic methods such as genomic analysis, microbiome profiling, and metabolite-based diagnostics for cases where early detection is challenging with morphological analysis, should be explored. These approaches could enable the identification of “pre-disease” states before the onset of symptoms, paving the way for “preventive medicine.”

This paper aims to discuss the potential of analyzing and intervening in the commensal microbiome as a novel approach to gastrointestinal cancer screening, based on our experiences in the Department of Medical Research on Prebiotics and Probiotics.