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.
Kubota
H
H
Second Department of Surgery, Shimane Medical University, Izumo, Japan.
Kotoh
T
T
Masunaga
R
R
Dhar
D K
DK
Shibakita
M
M
Tachibana
M
M
Kohno
H
H
Nagasue
N
N
D000368:Aged; D001464:Barium; D003625:Data Collection; D016145:Endoscopy, Digestive System; D005260:Female; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000191:economics / Q000401:mortality* / Q000473:pathology*; D016019:Survival Analysis
D001464:Barium