Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees.
OBJECTIVE
Early gastric cancer (EGC) can be treated by minimally invasive endoscopic resection and has an excellent prognosis. The aim of this study was to investigate whether repeated esophagogastroduodenoscopy (EGD) screening is an effective method for detecting EGC that can be treated by endoscopic resection.


METHODS
For patients diagnosed with gastric cancer in the Korean National Cancer Center screening program, we analyzed the incidence of gastric cancer, clinicopathological characteristics, and treatment modality according to whether they had (repeated screening group) or not (infrequent screening group) undergone EGD screening within 2 years before diagnosis.


RESULTS
Of the 18,414 patients who underwent EGD, 81 (0.44%) were found to have gastric cancer. Incidence of gastric cancer in repeated screening group was lower than that of infrequent screening group (multiple adjusted odds ratio=0.45, 95% confidence interval: 0.26-0.77, P=0.004). The proportion of EGCs was 96% (25 of 26) n the repeated screening group and 71% (34 of 48) in the infrequent screening group (P=0.01). Mean (SD) tumor size was smaller [1.9 (1.2) vs. 3.0 (1.6) cm, P=0.01] and the proportion of intramucosal cancer was higher [81% (21 of 26) vs. 50% (24 of 48), P=0.02] in the former than in the latter. Endoscopic resection was performed more frequently in the repeated screening group [54% (14 of 26) vs. 23% (11 of 48), P=0.007].


CONCLUSIONS
Repeated endoscopic screening within 2 years decreased the incidence of gastric cancer and endoscopic resection could be applied to more patients who underwent EGD screening within 2 years.
Nam
Su Youn
SY
Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Korea.
Choi
Il Ju
IJ
Park
Kyung Woo
KW
Kim
Chan Gyoo
CG
Lee
Jong Yeul
JY
Kook
Myeong-Cherl
MC
Lee
Jong Seok
JS
Park
Sook Ryun
SR
Lee
Jun Ho
JH
Ryu
Keun Won
KW
Kim
Young-Woo
YW
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D055088:Early Detection of Cancer; D016145:Endoscopy, Digestive System / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D016896:Treatment Outcome