title: Outcomes of mass screening for gastric carcinoma.
abstract: 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.
authors.affiliation: 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
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Junko
authors.initials: J
authors.lastname: Ishino
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakajima
authors.forename: Hisahiko
authors.initials: H
authors.lastname: Motohashi
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Akiyama
authors.forename: Masato
authors.initials: M
authors.lastname: Nomura
authors.forename: Goro
authors.initials: G
authors.lastname: Matsuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Hidetaka Andrew
authors.initials: HA
authors.lastname: Ono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: 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
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate