A comparative study of mass screenings for gastric cancer: indirect gastrofluororadiography and the serum pepsinogen test

概要

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The aim of the present study was to evaluate the advantage of using indirect gastrofluororadiography (XP) and the serum pepsinogen (PG) test in mass screenings for gastric cancer, especially for detecting endoscopically resectable (ER) cancer. A total of 1, 045 cases of gastric cancer were discovered among the 572,956 individuals who underwent the screening program of the Miyagi Cancer Society from April 2001 to November 2003. Of the gastric cancer cases, 371 cases examined with both XP and the PG test were divided into three groups: advanced cancer (invading the muscle layer proper), early cancer (limited in the submucosal layer) and ER cancer. On the one hand, XP had for a better detection rate for advanced cancer in comparison with the PG test (detection rates: XP 942%, PG 70.9%). On the other hand, the PG test had higher detection rates than XP for both early cancer (XP 56.8%, PG 73.3%) and ER cancer (XP 33.3%, PG 79.6%). The positive rates for either examination were 100, 88.7 and 82.8% in advanced, early and ER cancer groups, respectively. These results suggest that XP or the PG test on its own has difficulty in detecting early-stage cancers. It is desirable to detect gastric cancers in the earlier stages, such as ER cancer. The complementary combination of XP and the PG test may contribute to the qualitative improvement of mass screening programs, which are in ever increasing demand recently.