Two years' intensive training in endoscopic diagnosis facilitates detection of early gastric cancer.
OBJECTIVE
Early detection of gastric cancer by screening endoscopy facilitates endoscopic treatment in place of open surgery. The aim of this study was to evaluate whether 2 years intensive training improved the detection of gastric cancer by screening endoscopy.


METHODS
An endoscopist who had trained for 6 years as a general physician, performed screening endoscopy at Imari Arita Kyoritsu Hospital before (group I) and after (group II) intensive training in the diagnosis of early gastric cancer in consecutive patients.


RESULTS
Background characteristics, including age (61.6 vs. 62.2 years) and sex, did not differ between the groups. Before training, 10 gastric neoplasms were detected in 937 patients in group I: four early gastric cancers, one gastric adenoma, and five advanced gastric cancer. After training, 36 gastric neoplasms were detected in 937 patients in group II: 18 early gastric cancers, 11 gastric adenoma, five advanced gastric cancer, and one each of gastric carcinoid and malignant lymphoma. The detection rate for early gastric cancer was significantly improved by training [group I: 4/937 (0.4%) vs. group II: 18/937 (1.9%)], although the detection rate for advanced gastric cancer did not differ before and after training. The proportion of early gastric cancer + adenoma to advanced cancer was higher in group II (5/5 vs. 29/5 in group I).


CONCLUSIONS
Intensive training in upper gastrointestinal endoscopy screening dramatically improved the detection rate for early gastric cancer, although the detection rate for advanced gastric cancer was not affected.
Department of Gastroenterology, Tokyo Metropolitan Cancer Detection Center, Japan. yamazato5102086743@qa2.so-net.ne.jp
Tetsuro
T
Yamazato
Tsuneo
T
Oyama
Toshifumi
T
Yoshida
Yasumasa
Y
Baba
Kohei
K
Yamanouchi
Yoshitomo
Y
Ishii
Fumio
F
Inoue
Shuji
S
Toda
Kotaro
K
Mannen
Ryo
R
Shimoda
Ryuichi
R
Iwakiri
Kazuma
K
Fujimoto
D000236:Adenoma / Q000175:diagnosis; D000368:Aged; D002276:Carcinoid Tumor / Q000175:diagnosis; D055088:Early Detection of Cancer; D004502:Education, Medical, Continuing; D005260:Female; D005773:Gastroscopy / Q000193:education*; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis*