Effectiveness of the Small-Diameter Panendoscope in Diagnosing Cancers of the Upper Gastrointestinal Tract

Nishizawa, M; Nomoto, Kikuo; Hosoi, T.; Okada, Toshimasa; Yamada, Kento; Makino, Takashi; Shiga, T

doi:10.1055/s-2007-1021565

Cited by 9 publications

(6 citation statements)

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“…Very limited evidence supports the superiority of endoscopy over radiology in the detection of early GC. ( 9,31 ) Our study found that endoscopic screening was more sensitive for the detection of regional or distant GC (73.6%) than localized (65.7%) GC.…”

Section: Discussionmentioning

confidence: 64%

Performance of gastric cancer screening by endoscopy testing through the National Cancer Screening Program of Korea

et al. 2011

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Recent reports have proposed endoscopy as an alternative strategy to radiography for gastric cancer (GC) screening. The current study presents the first reported population-based data from a large GC screening program that provided endoscopic examinations. A retrospective population-based study was conducted using the National Cancer Screening Program (NCSP) database. We evaluated GC detection rates, sensitivity, specificity, and the positive predictive value of an endoscopic screening program for the average-risk Korean population, aged 40 years and older, who underwent the NCSP from 2002 to 2005. The detection rates of GC by endoscopy in the first and subsequent rounds were 2.71 and 2.14 per 1000 examinations, respectively. Localized cancer accounted for 45.7% of screen-detected GC cases. The sensitivity of endoscopy was 69% (95% confidence interval [CI]: 66.3-71.8). The endoscopic screening was less sensitive for the detection of localized GC (65.7%, 95% CI = 61.8-69.5) than for regional or distant GC (73.6%, 95% CI = 67.4-79.8). In the multiple logistic models for localized GC and all combined GC, the odds ratio (OR) of sensitivity for the undifferentiated type was statistically significantly higher than that for the differentiated type, whereas the OR of sensitivity for the mixed type was lower than that for the differentiated type. The sensitivity of the endoscopic test in a population-based screening was slightly higher for the detection of regional or distant GC than for localized GC. Further evaluation of the impact of endoscopic screening should take into account the balance of cost and mortality reduction. (Cancer Sci 2011; 102: 1559-1564 G astric cancer (GC) is the fourth most common type of cancer (934 000 new cases, 8.6% of all new cancer cases in 2002), and the second most common cause of cancer death (700 000 deaths annually) in the world.(1) Several Asian countries, including China, Japan, and Korea, have the highest incidences of GC in the world.(1) Although the incidence of GC in Korea has declined in recent decades, it remains the most common cancer. (2) Because the prognosis of early GC is highly favorable, highprevalence countries, such as Japan and Korea, have sought to reduce the disease burden by providing GC screening to average-risk populations. Since 1960, Japan has conducted mass screening for GC with photofluorography (via indirect upper gastrointestinal series), achieving remarkable improvement in survival rates as a result of early detection, and consequently, higher cure rates. (3)(4)(5) This use of photofluorography for GC screening in Japan is based on the results of several case-control and cohort studies.(6) Although population-based photofluorography screening has been mandated as a public policy matter, other opportunistic screening methods have been used in the clinical setting, including endoscopy, serum pepsinogen testing, and Helicobacter pylori antibody testing.(6) However, the efficacy of these methods remains unclear. In Korea, national GC screening was instituted i...

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Section: Discussionmentioning

confidence: 64%

Performance of gastric cancer screening by endoscopy testing through the National Cancer Screening Program of Korea

et al. 2011

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“…Previous studies have reported that endoscopy screening was suitable for diagnosis of a lesion involving the mucosal surface of the stomach [23]. Nishizawa et al [34] stated that endoscopy was more effective than a barium meal study for the detection of early gastric cancer. Kubota et al [35] also found that endoscopy screening allowed for the detection of smaller gastric tumors than did radiography screening.…”

Section: Discussionmentioning

confidence: 99%

Performance of Different Gastric Cancer Screening Methods in Korea: A Population-Based Study

et al. 2012

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BackgroundThere is a lack of agreement on which gastric cancer screening method is the most effective in the general population. The present study compared the relative performance of upper-gastrointestinal series (UGIS) and endoscopy screening for gastric cancer.MethodsA population-based study was conducted using the National Cancer Screening Program (NCSP) database. We analyzed data on 2,690,731 men and women in Korea who underwent either UGIS or endoscopy screening for gastric cancer between January 1, 2002 and December 31, 2005. Final gastric cancer diagnosis was ascertained through linkage with the Korean Central Cancer Registry. We calculated positivity rate, gastric cancer detection rate, interval cancer rate, sensitivity, specificity, and positive predictive value of UGIS and endoscopy screening.ResultsThe positivity rates for UGIS and endoscopy screening were 39.7 and 42.1 per 1,000 screenings, respectively. Gastric cancer detection rates were 0.68 and 2.61 per 1,000 screenings, respectively. In total, 2,067 interval cancers occurred within 1 year of a negative UGIS screening result (rate, 1.17/1,000) and 1,083 after a negative endoscopy screening result (rate, 1.17/1,000). The sensitivity of UGIS and endoscopy screening to detect gastric cancer was 36.7 and 69.0%, respectively, and specificity was 96.1 and 96.0%. The sensitivity of endoscopy screening to detect localized gastric cancer was 65.7%, which was statistically significantly higher than that of UGIS screening.ConclusionOverall, endoscopy performed better than UGIS in the NCSP for gastric cancer. Further evaluation of the impact of these screening methods should take into account the corresponding costs and reduction in mortality.

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“…There are some reports on the comparison of the diagnostic efficacy of fluoroscopy and panendoscopy (Lambert and Moulinier, 1979;C16mencon, 1980;Kill and Andersen, 1980;Nishizawa et al, 1982b) but our study based on 910 matched pairs may be the first well-controlled one on this problem. The superiority of panendoscopy, especially for the diagnosis of superficial lesions including early gastric cancer, was clearly demonstrated.…”

Section: Resultsmentioning

confidence: 86%

“…Since endoscopy is indicated for 20 to 40 percent of the patients examined by fluoroscopy, the total cost of the former becomes much greater. Nishizawa et al (1982b) carefully calculated the cost for detection of one early gastric cancer case by mass survey. In males over 50 years of age, for example, it is 1,800,000 yen by the fluoroscopy followed by endoscopy system and 500,000 yen by panendoscopy.…”

Section: Resultsmentioning

confidence: 99%

Detection of Early Gastric Cancer by Panendoscopy

Takasu

Tsuchiya

Kitamura

et al. 1984

Japanese Journal of Clinical Oncology

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With the implementation of a small-caliber panendoscope which was made according to our suggestion, we gradually replaced the conventional barium meal as the first line of the upper gastrointestinal tract examination by panendoscopy after 1976. The efficacy of panendoscopy for the early detection of gastric cancer in our 8-yr experience was investigated. In 910 matched pairs of patients subjected to "screening" fluoroscopy or panendoscopy two and six cases of early gastric cancer were detected respectively. Panendoscopy was superior to fluoroscopy in its sensitivity for detection of gastric cancer (86.4% vs. 80.0%), in its specificity (99.5% vs. 97.0%) and in its low false-positive rate (17.4% vs. 69.2%). After 1976, the detection of early gastric cancer increased year by year. The frequency of early gastric cancer detected by panendoscopy was about three times that of early gastric cancer detected by fluoroscopy (61.5% vs. 21.7% of all cancer). Early cancer located in the proximal third of the stomach and superficial esophageal cancer were detected only by panendoscopy. All gastric cancers that weie overlooked by panendoscopy were in the gastric body. How to prevent such overlooking is discussed. In 24,000 panendoscopies we have encountered six complications (0.03%). The cost of panendoscopy and fluoroscopy is 6,500 yen and 11,000 yen respectively.

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Effectiveness of the Small-Diameter Panendoscope in Diagnosing Cancers of the Upper Gastrointestinal Tract

Cited by 9 publications

References 0 publications

Performance of gastric cancer screening by endoscopy testing through the National Cancer Screening Program of Korea

Performance of gastric cancer screening by endoscopy testing through the National Cancer Screening Program of Korea

Performance of Different Gastric Cancer Screening Methods in Korea: A Population-Based Study

Detection of Early Gastric Cancer by Panendoscopy

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