Background
Gastric cancer (GC) remains a leading cause of cancer-related mortality in Europe, primarily due to late-stage diagnosis. While organised colorectal cancer (CRC) screening programs are well established, no structured gastric cancer screening strategy exists in most European countries, particularly in intermediate-risk regions such as Portugal and Spain. As demonstrated in previous European initiatives, this gap results in missed opportunities for early detection of premalignant lesions and curable early cancers.
Rationale
The VISTA trial builds directly on the epidemiological rationale, operational experience, and AI vision established in prior European translational screening initiatives.
It aims to evaluate two complementary, scalable gastric cancer screening pathways within existing healthcare infrastructures, generating high-quality evidence to inform future EU screening policies.
Objectives
To evaluate the feasibility, diagnostic yield, and safety of large-scale gastric cancer screening using transnasal endoscopy compared with opportunistic conventional gastroscopy within colorectal cancer screening programs (current benchmark).
Our Research Focus
• To estimate the prevalence of gastric cancer and premalignant gastric lesions (atrophy, intestinal metaplasia, dysplasia) detected by each screening strategy.
• To assess patient tolerance, acceptability, and procedural burden of transnasal endoscopy.
• To develop and validate AI models for:
- Automated gastric image analysis and lesion detection
- Quality assessment of mucosal inspection
- Screening optimization using integrated clinical, demographic, and endoscopic data.
• To generate epidemiological data supporting evidence-based gastric cancer screening strategies in intermediate-risk European populations.
Omae Masami,
Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden.
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This project has received funding from the European Union’s Horizon Europe research and innovation programme under grant agreement Nº XXXXX.