Impact of endoscopic screening on mortality reduction from gastric cancer

doi:10.3748/wjg.v21.i8.2460

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World Journal of Gastroenterology

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World J Gastroenterol. Feb 28, 2015; 21(8): 2460-2466
Published online Feb 28, 2015. doi: 10.3748/wjg.v21.i8.2460

Impact of endoscopic screening on mortality reduction from gastric cancer

Satoshi Tsukioka, Masatoshi Sano, Kazutaka Fujita, Toshiyuki Kato, Tomoki Kishi, Rintarou Narisawa, Kazuei Ogoshi, Chisato Hamashima

Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan

Kazuei Ogoshi, Cancer Registry Section, Niigata Cancer Center Hospital, Niigata 951-8566, Japan

Rintarou Narisawa, Toshiyuki Kato, Division of Gastroenterology, Niigata Cancer Center Hospital, Niigata 951-8566, Japan

Tomoki Kishi, Graduate student, Department of Health Management, Keio University, Fujisawa 252-0882, Japan

Kazutaka Fujita, Masatoshi Sano, Committee of Gastrointestinal Cancer Screening, Niigata city Medical Association, Niigata 951-8131, Japan

Satoshi Tsukioka, Niigata city Public Health Center, Niigata city Government, Niigata 950-1197, Japan

Author contributions: Ogoshi K, Hamashima C, and Narisawa R designed the study; Kato T, Fujita K, Sano M, and Tsukioka S performed the follow-up survey and collected data; Hamashima C and Kishi T conducted the statistical analysis; Ogoshi K, Hamashima C, and Narisawa R wrote the initial draft of the article, which was revised and approved by the authors.

Supported by Grant-in-Aid for H22-Third Term Comprehensive Control Research for Cancer 022 from the Japanese Ministry of Health, Labour and Welfare.

Correspondence to: Chisato Hamashima, MD, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan. chamashi@ncc.go.jp

Telephone: +81-3-35475305 Fax: +81-3-35478587

Received: July 29, 2014
Peer-review started: July 29, 2014
First decision: August 15, 2014
Revised: September 4, 2014
Accepted: November 11, 2014
Article in press: November 11, 2014
Published online: February 28, 2015
Processing time: 214 Days and 7.2 Hours

Abstract

AIM: To investigate mortality reduction from gastric cancer based on the results of endoscopic screening.

METHODS: The study population consisted of participants of gastric cancer screening by endoscopy, regular radiography, and photofluorography at Niigata city in 2005. The observed numbers of cumulative deaths from gastric cancers and other cancers were accumulated by linkage with the Niigata Prefectural Cancer Registry. The standardized mortality ratio (SMR) of gastric cancer and other cancer deaths in each screening group was calculated by applying the mortality rate of the reference population.

RESULTS: Based on the results calculated from the mortality rate of the population of Niigata city, the SMRs of gastric cancer death were 0.43 (95%CI: 0.30-0.57) for the endoscopic screening group, 0.68 (95%CI: 0.55-0.79) for the regular radiographic screening group, and 0.85 (95%CI: 0.71-0.94) for the photofluorography screening group. The mortality reduction from gastric cancer was higher in the endoscopic screening group than in the regular radiographic screening group despite the nearly equal mortality rates of all cancers except gastric cancer.

CONCLUSION: The 57% mortality reduction from gastric cancer might indicate the effectiveness of endoscopic screening for gastric cancer. Further studies and prudent interpretation of results are needed.

Keywords: Gastric cancer screening; Mortality; Upper gastrointestinal endoscopy; Upper gastrointestinal radiography; Standardized mortality ratio

Core tip: We investigated mortality reduction from gastric cancer on the basis of results of endoscopic screening. The standardized mortality ratio (SMR) of gastric cancer and other cancer deaths in each screening group was calculated by applying the mortality rate of the reference population. Based on the results calculated from the mortality rate of the population of Niigata city, the SMRs of gastric cancer death were 0.43 (95%CI: 0.30-0.57) for the endoscopic screening group. The 57% mortality reduction from gastric cancer might indicate the effectiveness of endoscopic screening for gastric cancer.