Perspectives

How does GastroPanel® perform as a triage system for gastric cancer risk assessment?

Gastric cancer (GC) remains a significant health burden and represents about 5.6% of new cancer cases worldwide. This burden is projected to only increase if current rates persist. According to estimates, there will be approximately 28.4 million cancer cases by 2040, a 47% increase compared to 2020 (1).

In 2020, gastric cancer accounted for about 7.7% of all cancer-related deaths (~769,000 in total), making it one of the most lethal cancers globally. For instance, the 5-year survival rate in the UK is only 22%, with 1-year survival at 48% (2,3). The poor prognosis stems largely from late-stage diagnosis.

Despite this, evidence also shows that a significant proportion of upper gastrointestinal endoscopies in patients with dyspepsia reveal no significant gastric pathology, indicating that this valuable specialist resource is overused in low-risk patients.

Two recent clinical studies indicate that Biohit’s GastroPanel test is an effective triage tool for identifying gastric cancer risk in patients while reducing unnecessary gastroscopic procedures in low risk individuals (2, 3).

“GastroPanel® can be used for triaging patients by differentiating cases with functional dyspepsia from those with moderate to severe extensive AG who need image-enhanced endoscopy.” (3)

Can triage reduce unnecessary gastroscopies?

Current clinical practice relies on gastroscopy to identify patients with atrophic gastritis (AG), the most important precancerous condition for gastric adenocarcinoma (GAC). GAC is the most common type of gastric cancer, as it accounts for 90%–95% of all gastric cancer cases (3).

However, endoscopy services are experiencing unprecedented pressure, with UK studies reporting up to 44% increase in demand over 5 years (4). Experts agree there is a need for an effective triage tool to estimate patients’ need for gastroscopy at the point of referral.

Most concerning is that gastroscopic procedures are invasive and often unnecessary. Being able to select patients for endoscopy based on need could lead to earlier detection and diagnosis of gastric cancer and therefore improve outcomes for patients with the disease through earlier, targeted intervention.

Without a functional and accurate triage tool, patients with functional dyspepsia undergo time-consuming and invasive examinations that yield no actionable findings, blocking the patient pathway and leaving high-risk patients in long waiting lists.

GastroPanel®: A non-invasive triage tool for dyspeptic patients

GastroPanel quick test NT is the next step in the evolution of triage tests for gastric symptoms, progressing laboratory-based ELISA technology into a point of care test. Using immunological lateral-flow technology, the test detects the same four biomarkers (pepsinogen I, pepsinogen II, gastrin-17, and H. pylori antibodies) from either finger-prick whole blood or EDTA-plasma samples that can be used in any clinical setting. What’s more, actionable results are delivered in just 15 minutes.

The test identifies moderate to severe atrophic gastritis of the corpus (AGC). This is the highest-risk condition requiring endoscopic surveillance according to the 2019 British Society of Gastroenterology guidelines (5). They state that non-invasive identification of those at risk before endoscopy is the key to early cancer detection and survival.

GastroPanel is a first-line, cost-effective and non-invasive diagnostic triage tool for detecting atrophic gastritis, the most clinically relevant precursor to gastric cancer.

“GastroPanel is a first-line, cost-effective and non-invasive diagnostic triage tool for detecting atrophic gastritis, the most clinically relevant precursor to gastric cancer.”

Learn more: GastroPanel® quick test NT

Evidence from two clinical studies

Two recent clinical validation studies from India (2) and the UK (3) demonstrate that GastroPanel can reliably identify patients at high risk for gastric cancer. This method of testing can eliminate up to 80% of unnecessary gastroscopies with the timely detection of precancerous conditions.

Papadia et al. (2025): GastroPanel® as a triage tool to select patients with advanced atrophic gastritis for gastroscopy

The study conducted by Homerton University in the United Kingdom, examined 268 dyspeptic patients referred for gastroscopy, finding an 11.9% prevalence of atrophic gastritis. GastroPanel demonstrated:

• 90% overall agreement with Updated Sydney System (USS) histology classification.

• 99.6% specificity for detecting moderate/severe corpus atrophy.

• 75% sensitivity for moderate/severe corpus atrophy.

Using Fagan’s nomogram analysis, researchers calculated that a positive GastroPanel® result predicts moderate/severe atrophic gastritis with 86% probability, while a negative result reduces the likelihood to just 1%.

“GastroPanel® is a reliable triage test capable of distinguishing patients with dyspepsia who can be safely followed up and treated conservatively, from those at high risk of developing GAC,” the authors state (3).

Chhabra et al. (2025): Point-of-Care diagnosis of atrophic gastritis

The study conducted by Fortis Hospital and Research Centre in India, of 249 patients found a 15.3% prevalence of biopsy-confirmed atrophic gastritis. The GastroPanel® quick test NT showed:

• 71.4% overall agreement between the GastroPanel quick test NT and the USS classification.

• Excellent diagnostic accuracy for moderate/severe corpus atrophy (PGI: AUC = 0.990 and for PGI/PGII ratio: AUC = 0.971).

• Results in just 15 minutes from a finger-prick blood sample.

The study concluded that the GastroPanel quick test NT favorably competes in diagnostic accuracy with the previous GastroPanel ELISA-versions in large-scale clinical and screening settings worldwide (2).

The clinical impact of patient triaging for gastric cancer diagnosis

Currently, many patients with functional dyspepsia undergo unnecessary gastroscopy creating bottlenecks in healthcare services and delaying diagnosis. GastroPanel’s high negative predictive value means patients with normal results do not have to undergo invasive procedures.

For healthcare systems, this translates to:

• Reduced unnecessary gastroscopies in low-risk patients.

• Prioritized endoscopy capacity for individuals at high risk of GC.

• Faster access to clinical triage and earlier detection of precancerous lesions.

• Cost savings from unnecessary appointments and procedures.

• Improved patient safety and increased satisfaction through non-invasive testing methods.

Conclusion

GastroPanel offers a first-line, cost-effective and non-invasive diagnostic triage tool that detects the most clinically relevant precursor to gastric cancer – atrophic gastritis – to select patients for endoscopy.

By accurately identifying patients with high-risk atrophic gastritis, GastroPanel enables healthcare systems to direct resources where they matter most, while sparing many patients from unnecessary invasive procedures.

Contact our experts to hear more about GastroPanel and its use in diagnosing dyspeptic patients.