Estimation of validity of mass screening program for gastric cancer in Osaka, Japan

Murakami, Ryosuke; Tsukuma, Hideaki; Ubukata, Takashi; Nakanishi, K.; Fujimoto, Isaburo; Kawashima, Teruaki; Yamazaki, Hideo; Oshima, Akira

doi:10.1002/1097-0142(19900301)65:5<1255::aid-cncr2820650536>3.0.co;2-p

Cited by 62 publications

(23 citation statements)

References 6 publications

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“…There has been widespread population screening by radiological means in Japan since the late 1960s, which could have inflated incidence figures through increased detection [3,4,9,12,13]. Nonetheless, it is relevant to observe that age-sex standardized (world population) mortality rates circa 1993 also showed a marked elevation, with the rate being approximately five to six times higher in Japan than for the United States and Canada, and four to five times higher than for Australia and New Zealand [14].…”

Section: Incidencementioning

confidence: 99%

“…Male-to-female ratio of agestandardized (world population) incidence rates for gastric cancer by subsite and region of the world: diagnostic period, circa 1990. Data source: Cancer incidence in five continents (volume VII) [8] 1977-1981 Baseline rates set to "1.00" a Data source: SA Cancer Registry [7] cancer mortality of around 50%, the effects cannot be assessed with certainty without a randomized trial [12,[27][28][29][30]. Such a trial reportedly is underway, with Japanese municipalities being used as the unit of random allocation [13].…”

Section: All Subsites (In Total)mentioning

confidence: 99%

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The epidemiology of gastric cancer

2002

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Section: Incidencementioning

confidence: 99%

Section: All Subsites (In Total)mentioning

confidence: 99%

The epidemiology of gastric cancer

2002

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“…The most common method used in photofluorographic studies is to follow-up persons screened negative and to ascertain the cancer cases occurring among them through a record linkage to a population-based cancer registry and other data sources. Table 1 summarizes the sensitivity and specificity of gastric photofluorography assessed by 1-year follow-up studies [12][13][14][15][16][17][18][19][20][21]. Two definitions of false-negative have been used.…”

Section: Accuracy Of Screening Photofluorographymentioning

confidence: 99%

“…The studies generally showed an acceptable accuracy. Murakami et al [20] reported that photofluorography with an image intensifier and direct radiography had comparable sensitivity (88.5% and 90.8%, respectively) and specificity (92.0% and 91.4%, respectively).…”

Section: Accuracy Of Screening Photofluorographymentioning

confidence: 99%

Screening for gastric cancer in Japan

2000

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In Japan, mass screening for gastric cancer with photofluorography was initiated in 1960. At present, over 6 million people are screened annually. The sensitivity and specificity of photofluorography are 70%-90% and 80%-90%, respectively. The 5-year survival rate is 15%-30% better in screendetected cancers than in symptom-diagnosed cases. Although no randomized controlled trials have been reported, cohort and case-control studies generally showed a decreased risk of mortality from gastric cancer in the screened subjects. The summary odds ratio (95% confidence interval) of three casecontrol studies for ever screened versus never screened subjects was 0.39 (0.29-0.52) for men and 0.50 (0.34-0.72) for women. Substantial evidence indicates that the Japanese screening program with photofluorography is effective in reducing the mortality from gastric cancer. The measurement of serum pepsinogens has recently drawn attention as an alternative to photofluorography, given its lower cost and simplicity. Some studies have suggested a comparable accuracy for the two methods. However, these investigations may have overestimated the relative sensitivity of serum pepsinogen testing compared with photofluorography, because serum pepsinogen testing was conducted as prevalent screening, while photofluorography was done as incident screening. Furthermore, no studies have directly examined whether the screening with serum pepsinogens reduced gastric cancer mortality. Therefore, at present, evidence is insufficient to determine the benefit of this program.

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“…Contrast fluorography and fibrogastroscopy (FGS) are the most efficient methods of GC screening. FGS is three times less expensive for early diagnosis, although it does require greater skills from the endoscopist (3,4).…”

Section: Diagnosismentioning

confidence: 99%

Current practice for gastric cancer treatment in Ukraine

Sydiuk

2017

Transl. Gastroenterol. Hepatol.

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IntroductionGastric cancer (GC) is a significant and unsolved problem, despite a slight decrease in its morbidity. Globally, 952,000 new GC cases were registered in 2012. In South Korea and Japan, because of screening for GC, the 5-year survival rate is more than 60%. In most other countries, this value is 2-3 times lower (1,2). In Ukraine, GC is a serious problem. Annually, the country registers more than 8,000 new GC cases. The disease is usually diagnosed at stage III-IV (65% of cases) and 62.2% of patients die within 1 year. About 70% of patients with GC need chemotherapy, and for most of them, this is the only way to increase their life expectancy. Morbidity and death rateAccording to the national cancer register of Ukraine, there were 8,350 new cases of GC in 2014 (5,104 in men and 3,246 in women). Thus, the morbidity rate is 23.0 cases per 100,000 people (30.3 for men and 16.7 for women), which puts the disease in fourth place for men and eighth place for women for morbidity as a result of malignant tumors in Ukraine. During the period under investigation, 6,414 patients diagnosed with GC died. The death rate was 17.7 cases per 100,000 people (23.8 for men and 12.3 for women), which means that, for men and women respectively, GC has the second and third highest death rates from malignant tumors in Ukraine.People diagnosed with GC for the first time are diagnosed at the following stages according to the TNM classification: stage I-II, 37.6%; stage III, 22.5%; stage IV, 33.9%; and indistinct stage, 5%. Thus, advanced GC is diagnosed for the first time in as many as 60% of all patients, which leads to a high death rate of more than 50% during the first year.The above information allows us to conclude that the early diagnosis of GC, as well as combined methods of treating it with neo-adjuvant and adjuvant therapy, is of paramount importance in Ukraine.Despite the gradual decline in GC morbidity, there are still some serious associated problems. Namely, in the last 10 years, the following was noted ( Table 1): (I) very few changes in the morbidity rate for women; (II) decrease in the diagnosis of stage I-II disease in spite of the necessary endoscopic equipment; (III) high death rate within 1 year.Given this information, we should define the most of patients with GC need chemotherapy, and for most of them, this is the only way to increase their lifeexpectancy. An unsolved problem of nationwide importance is achieving the early diagnosis of GC, which predetermines the treatment outcome. The 5-year survival rate for GC patients in Ukraine is only 13%, while early diagnosed GC is almost totally curable using surgery. Another important task is the development of national diagnosis and treatment standards, which will be based on national breakthroughs and will meet modern international requirements.

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Estimation of validity of mass screening program for gastric cancer in Osaka, Japan

Cited by 62 publications

References 6 publications

The epidemiology of gastric cancer

The epidemiology of gastric cancer

Screening for gastric cancer in Japan

Current practice for gastric cancer treatment in Ukraine

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