Present Situation of and Future Prospects for Gastric Cancer Examination for the Elderly

概要

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The aging of society has brought about an urgent need to review the examination procedures for gastric cancer in the elderly. This report examines the status quo of, and possible future improvements to be made to gastric cancer examination for the elderly, from the viewpoints of mass surveys and individual check-ups. A mass survey revealed that people aged sixty-five or older comprise approximately 40% of the total number of examinees. The detection rate for gastric cancer increases with age, and the early detection rate for the elderly was the same as that for people under sixty-five. The examination efficiency was found to have improved through the use of high-concentration barium, and the implementation rate of endoscopic mucosal resection (EMR) for the elderly has shown a tendency to increase. However, a decrease in diagnostic accuracy and an increase in accidental symptoms have become significant issues in X-ray examinations of the elderly. In contrast, the serum pepsinogen test (PG) performed at individual check-ups demonstrated higher consultation and detection rates, as well as better cost-effectiveness than X-ray examinations. In conclusion, it is recommended that PG should be introduced as the first step in the examination of an elderly patient, as it will raise the consultation rate and lead to the performance of an endoscopy when necessary.