Comparing mass screening techniques for gastric cancer in Japan.
OBJECTIVE
To discuss the efficacy of endoscopic mass screening for gastric cancer.


METHODS
The data used in this study were the results of mass screening programs for gastric cancer in Niigata City from 2002 to 2004. The number of participants was 35,089 in 2002, 34,557 in 2003 and 36,600 in 2004. The finding ratio referred to the final diagnosis of gastric cancer after a double check of endoscopic files and histological findings. The costs of identifying one case of gastric cancer were calculated based on the total expense for each screening program and additional close examinations.


RESULTS
From the analysis of individual screening program with endoscopy, individual screening program with X-ray (ISX) and mass screening program with photofluorography (MSP) in reference to the finding ratio of gastric cancer, endoscopic examination was the best for detecting early gastric cancer, the finding ratio was 0.87% in 2004, approximately 2.7 and 4.6 times higher than those of the ISX and MSP groups. In addition, this novel method was the cheapest means regarding the cost of identifying one case of gastric cancer, which was estimated to be 1,608,000 Japanese yen in 2004.


CONCLUSIONS
Endoscopic mass screening is a promising method and can be effectively applied if a sufficient number of skilled endoscopists become available to staff the system and if city offices support it.
Tashiro
Atsushi
A
Niigata Public Health and Sanitation Center, 1-602-1 Gakkocho-dori Niigata 951-8550, Japan. tashi@mail.lamen.or.jp
Sano
Masatoshi
M
Kinameri
Koichi
K
Fujita
Kazutaka
K
Takeuchi
Yutaka
Y
D004724:Endoscopy / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D013274:Stomach Neoplasms / Q000175:diagnosis*