How is gastrointestinal (GI) or stomach cancer diagnosed?

Because stomach cancer is relatively uncommon in the United States, there are no general screening tests recommended for stomach cancer like mammograms for breast cancer or colonoscopies for colon cancer. When doctors suspect stomach cancer, they may order several tests to make a diagnosis and/or stage the disease.

  • Medical history and physical exam. The doctor feels the abdomen for swelling, fluid or other changes. He also checks for swollen lymph nodes.
  • Imaging tests. Pictures of the inside of the body can help find out whether a suspicious area might be cancerous, to learn how far cancer may have spread and to help determine if treatment is working.
  • Endoscopy. Endoscopy allows the doctor to see the lining of the upper digestive system with a thin, lighted, flexible tube called an endoscope. A person is sedated as the tube is inserted through the mouth, down the esophagus, and into the stomach and small bowel. If an abnormality is found, a biopsy is performed.
  • Endoscopic ultrasound. An ultrasound uses sound waves to create a picture of the internal organs. This procedure is often done at the same time as the upper endoscopy. The endoscopic ultrasound can show enlarged lymph nodes, which may indicate a tumor or advanced disease.
  • Computed tomography (CT). A CT scan creates a three-dimensional X-ray of the inside of the chest, abdomen and pelvis. A computer combines the images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (dye) is used to provide better detail.
  • Laparoscopy. This minimally invasive procedure allows the doctor to view the lymph nodes and other organs to see if cancer has spread. Biopsies may be taken of the organ tissue.
  • Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a person's body. The tumor absorbs the radioactive substance, and a scanner detects this substance to produce images.
  • Biopsy. When other tests find a change that is possibly cancer, a sample of the suspicious area is removed and viewed under a microscope. A biopsy or fine-needle aspiration is the only way to tell if cancer is really present.
  • Lab tests. A doctor may order lab tests to check levels of carcinoembryonic antigen (CEA), protein and enzyme levels that may indicate cancer.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.