Outcomes of mass screening for gastric carcinoma.
BACKGROUND
Therapeutic results of gastric cancer have been improved by early detection of gastric cancer with the mass screening system in Japan. The objective of our study was to assess the efficacy of mass screening for gastric cancer by using a barium meal.


METHODS
A series of 1050 patients (364 in the screened group and 686 in the nonscreened group) were included in this study from April 1992 to March 2000. Patient characteristics, therapeutic results, and prognostic factors were compared in the two groups.


RESULTS
The screened patients tended to be younger and male, with tumors in the middle third of the stomach that were of a macroscopically superficial type, with a smaller diameter, and at an earlier stage. They had fewer metastatic lymph nodes and underwent more frequent curative resection. Among the screened patients with curatively resected disease, tumors tended to be of a smaller diameter, and there were fewer metastatic lymph nodes in both early and advanced cases. Disease-specific survival was significantly better in the screened cases among all registered and curatively resected patients. Mass screening achieved significantly better surgical results in early or advanced gastric cancer patients who received curative resection. Multivariate analysis revealed that mass screening was an independent prognostic factor (hazard ratio, .3949; P < .0001), together with depth of invasion, lymph node metastasis, age, and tumor diameter.


CONCLUSIONS
Mass screening by using barium meal examination for gastric cancer detects cancer at an early stage and produces good therapeutic results.
Kunisaki
Chikara
C
Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, 3-9 Fukuura Kanazawaku, Yokohama 236-0004, Japan. s0714@med.yokohama-cu.ac.jp
Ishino
Junko
J
Nakajima
Susumu
S
Motohashi
Hisahiko
H
Akiyama
Hirotoshi
H
Nomura
Masato
M
Matsuda
Goro
G
Otsuka
Yuichi
Y
Ono
Hidetaka Andrew
HA
Shimada
Hiroshi
H
D001466:Barium Sulfate / Q000191:economics; D016022:Case-Control Studies; D003287:Contrast Media / Q000191:economics; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008207:Lymphatic Metastasis; D008297:Male; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D015996:Survival Rate
D003287:Contrast Media; D001466:Barium Sulfate