Current status and problems of screening for gastric cancer using endoscopy

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Although high accuracy of mass screening for gastric cancer using endoscopy is necessary in order to further promote the screening program, it is recognized that many problems inherent in this method are yet to be solved, and that suitable countermeasures are yet to be provided. In this paper, the current status and problems of mass screening for gastric cancer using endoscopy are investigated with the help of the records of a one-day complete physical checkup undertaken at JA Kohseiren Medical Health Care Center in Kagoshima. Screening tests for diseases of the esophagus, the stomach and the duodenum were performed for 71, 939 subjects over a period of 5 years, from 1997 to 2001. Only 5.6% of cases had endoscopy performed, while the others (94.4%) underwent direct fluororadiography. The records of the screening for gastric cancer us ing endoscopy were compared with those for which radiography (direct and indirect) was used. The results were as follows: 1) The rate of checkup for gastric cancer by endoscopy was 0.24%, by direct fluororadiography 0.10%, and by indirect fluororadiography 0.12%. 2) More staff was required for screenings using endoscopy than for those using radiography. For screening 80 persons in a single day using endoscopy, almost 2,610,000 yen were required, while only 1,040,000 yen were required for indirect gastrointestinal-fluororadiography. In conclusion, accuracy of mass screening using endoscopy is high, but efficiency is low. Henceforth, the education of staff dealing with endoscopy and the construction of better systems displaying higher accuracy are required for making mass screening for gastric cancer using endoscopy a standard procedure.
一般社団法人日本消化器がん検診学会の論文

Current status and problems of screening for gastric cancer using endoscopy

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