What is the initial test to evaluate gastric cancer?

• A. Biopsy
• B. Upper endoscopy
• C. CT scan
• D. Stool occult blood test

Answer: (B)

The initial test to evaluate gastric cancer is upper endoscopy. This procedure, also known as esophagogastroduodenoscopy (EGD), allows the physician to visually inspect the lining of the stomach and obtain biopsies if needed. During the endoscopy, a flexible tube with a camera is passed through the mouth, down the esophagus, and into the stomach, enabling precise observation and intervention.

Upper endoscopy is crucial because it not only helps in the direct visualization of any abnormalities such as tumors or lesions but also allows for tissue samples to be collected for histopathological analysis. This is important for confirming a diagnosis of gastric cancer, as it can distinguish cancerous changes from benign conditions.

Other diagnostic methods, such as imaging studies like a CT scan, may be used later to assess the extent of disease or to evaluate nearby structures, but they are not the initial tests for diagnosis. Stool occult blood tests can indicate gastrointestinal bleeding, which can be associated with gastric cancer, but they do not provide definitive evidence of cancer. Biopsy refers specifically to the collection of tissue for pathological examination, which cannot be performed without the initial step of endoscopy in this context.