title: No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk.
abstract: BACKGROUND
  Gastric cancer (GC) is the leading cause of cancer deaths in China. Our study prospectively evaluated the impact of repeated endoscopic screens on GC mortality in a high-risk population in China.
  
  
  METHODS
  Between 1989 and 1999, a population-based gastroscopic screening was conducted in 4,394 residents of Linqu County, China, a region with the highest rates of GC worldwide. Residents ages 35 to 64 years received initial gastroscopies with biopsies in 1989. Repeated endoscopies were performed in 1994 and 1999. Cancer occurrences and deaths were actively monitored throughout the entire period until July 2000. Mortality from GC was compared with expected values based on mortality rates obtained for Linqu in the 1990-1992 Chinese Cancer Mortality Survey.
  
  
  RESULTS
  Between March 1989 and July 2000, 39,303 person-years were accumulated; 85 new GCs occurred, 29 (34.5%) were in early stage. Fifty-eight cases (68%) were identified at one of the screens. The number of observed deaths from GC (37) was close to the expected (36.8). The standardized mortality ratio was 1.01 (95% CI 0.72-1.37) for the entire cohort, 1.13 (95% CI 0.77-1.57) for males, and 0.65 (95% CI 0.26-1.32) for females.
  
  
  CONCLUSIONS
  Despite high population coverage with repeated screens, no reduction in GC mortality was observed in this high-risk population in China.
authors.affiliation: Department of Gastroenterology and Hepatology, Freiburg University Hospital, Freiburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Riecken
authors.forename: R
authors.initials: R
authors.lastname: Pfeiffer
authors.forename: J L
authors.initials: JL
authors.lastname: Ma
authors.forename: M L
authors.initials: ML
authors.lastname: Jin
authors.forename: J Y
authors.initials: JY
authors.lastname: Li
authors.forename: W D
authors.initials: WD
authors.lastname: Liu
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: Y S
authors.initials: YS
authors.lastname: Chang
authors.forename: M H
authors.initials: MH
authors.lastname: Gail
authors.forename: W C
authors.initials: WC
authors.lastname: You
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005773:Gastroscopy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000473:pathology; D016896:Treatment Outcome