Original Communications| Volume 128, ISSUE 1, P41-47, July 2000

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Impact of screening survey of gastric cancer on clinicopathological features and survival: Retrospective study at a single institution


      Background: Detection of gastric cancer in an early stage is important to improve the prognosis of patients with gastric cancer. This study compared the clinicopathologic characteristics and surgical results in patients with asymptomatic gastric cancer detected by a screening program with those of patients with symptomatic cancer. The efficacy of 2 screening methods (barium meal and endoscopy) was also compared. Methods: The subjects included 196 patients with asymptomatic gastric cancer detected by screening (screening group) and 612 patients with symptomatic gastric cancer (nonscreening group) treated from 1979 to 1997. The screening group was subdivided into the barium meal study group (n = 150) and the endoscopic study group (n = 46). Results: The incidences of early gastric cancer and 5-year survival rates between the screening and nonscreening groups were 77% versus 29% (P <.0001) and 81% versus 44% (P <.0001), respectively. The endoscopic study appeared to be able to detect smaller gastric cancer in an earlier stage compared with the barium meal study, although no statistical differences in survival rate were noted between these 2 screening methods. Conclusions: Screening plays an important role in detecting gastric cancer in an early stage and in potentially reducing death attributable to gastric cancer. Endoscopic screening is recommended as the best screening method. (Surgery 2000;128:41-7)
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        • Health and Welfare Statistics Association
        Death rates and age-adjusted death rates from malignant neoplasms by site and sex, 1980-1995. In Health and Welfare in Japan.
        : Health and Welfare Association, Tokyo1996
        • Tominaga S
        • Aoki K
        • Fujimoto I
        • Kurihara M.
        Cancer mortality and morbidity statistics. Japan and the world—1994.
        Gann Monograph on Cancer Research. 1994; 41: 175-177
        • Asao K.
        A Japanese view of American early gastric cancer detection.
        Gastroenterology. 1990; 99: 1189-1190
        • Okamura T
        • Tsujitani S
        • Korenaga D
        • Haraguchi M
        • Baba H
        • Hiramoto Y
        • et al.
        Lymphadenectomy for cure in patients with early gastric cancer and lymph node metastasis.
        Am J Surg. 1988; 155: 29-33
        • Wanebo HJ
        • Kennedy BJ
        • Chmiel J
        • Steele G
        • Winchester D
        • Osteen R.
        Cancer of the stomach: a patient care study by American College of Surgeons.
        Ann Surg. 1993; 218: 583-592
        • Ohshima A
        • Hirata N
        • Ubukata T
        • Umeda K
        • Fujimoto I.
        Evaluation of a mass screening program for stomach cancer with a case-control study design.
        Int J Cancer. 1986; 38: 829-833
        • Fukao A
        • Tsubono Y
        • Tsuji I
        • Hisamichi S
        • Sugahara N
        • Takano A.
        The evaluation of screening for gastric cancer in Miyagi prefecture, Japan. A population-based case-control study.
        Int J Cancer. 1995; 60: 45-48
        • Hisamichi S.
        Screening for gastric cancer.
        World J Surg. 1989; 13: 31-37
        • Nishidoi H
        • Kimura O
        • Makino M
        • Sugezawa A
        • Kaibara N.
        Clinicopathological features of advanced gastric cancer detected by periodic mass screening.
        Jpn J Surg. 1992; 22: 120-123
        • Matsukuma A
        • Furusawa M
        • Tomoda H
        • Seo Y.
        A clinico-pathological study of asymptomatic gastric cancer.
        Br J Cancer. 1996; 74: 1647-1650
      1. 5th edition. TNM classification of malignant tumours. International Union Against Cancer. John Wiley & Sons, New York1997
        • Laurén P.
        The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma.
        Acta Path et Microbiol Scandinav. 1965; 64: 31-49
        • Llorens P.
        Gastric cancer mass survey in Chile.
        Semin Surg Oncol. 1991; 7: 339-343
        • Pisani P
        • Oliver WE
        • Parkin DM
        • Alvarez N
        • Vivas J
        Case-control study of gastric cancer screening in Venezuela. 69. 1994
        • Wang B
        • Yanagawa H
        • Sakata K.
        Gastric cancer screening programme in Japan: how to improve its implementation in the community.
        J Epidemiol Community Health. 1994; 48: 182-187
      2. Mechanic D. Strategies for health promotion. In: Proceedings of the Second International Conference of Health Behavioral of Science in Tokyo, Sept 27-29,4-11, 1991.

        • Nishizawa M
        • Nomoto K
        • Hosoi T
        • Okada T
        • Yamada K
        • Makino T
        • et al.
        Effectiveness of the small-diameter panendoscope in diagnosing cancers of the upper gastrointestinal tract.
        Endoscopy. 1982; 14: 19-21
        • Hanazaki K
        • Sodeyama H
        • Wakabayashi M
        • Miyazawa M
        • Yokoyama S
        • Sode Y
        • et al.
        Surgical treatment of gastric cancer detected by mass screening.
        Hepatogastroenterology. 1997; 44: 1126-1132
        • Babazono A
        • Hillman AL
        Declining cost-effectiveness of screening for disease. The case of gastric cancer in Japan.
        Intl J Technol Assess Health Care. 1995; 11: 354-364
        • Siersema PD
        • Dees J
        • Tilanus HW
        • Kok TC
        • Hordijk ML
        • van Blankenstein M.
        Early detection and treatment of esophageal and gastric cancer.
        Neth J Med. 1995; 47: 76-86