Association of the interval between endoscopies with gastric cancer stage at diagnosis in a region of high prevalence.
BACKGROUND
Endoscopy screening in high-risk populations may reduce gastric cancer mortality by detecting cancer earlier. We evaluated the association between the interval between upper gastrointestinal endoscopies and the gastric cancer stage at diagnosis in patients from a region of high prevalence.


METHODS
The study cohort consisted of 2485 patients diagnosed with gastric adenocarcinoma. We evaluated the effect on cancer stage of the interval between the endoscopy that was diagnostic for gastric cancer and the endoscopy preceding it. Patients were stratified into 7 groups: 1-, 2-, 3-, 4-, 5-, >5-year intervals and those who were never screened.


RESULTS
The risk of higher cancer stage at diagnosis increased by 23% per increase in interval length (odds ratio = 1.23, 95% confidence interval [CI] = 1.19-1.28). Compared to the never-screened, the odds ratio of having a higher stage of cancer decreased gradually from 0.53 (95% CI = 0.41-0.69) in the >5-year interval group to 0.31 (95% CI = 0.24-0.40) in the 1-year interval group. Compared to the 1-year interval group, the risk of advanced gastric cancer was increased in the 4- and 5-year, but not the 2- and 3-year, interval groups. However, patients with a family history of gastric cancer were more likely to have a higher stage at diagnosis if they had a 3-year interval rather than a 1-year interval.


CONCLUSIONS
A significant benefit in cancer stage at diagnosis was observed in all interval groups compared to never-screened. Endoscopy intervals of 3 years or less showed similar benefits, but family members of gastric cancer patients may benefit from intervals of under 3 years.
Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Republic of Korea.
Ji Hyung
JH
Nam
Il Ju
IJ
Choi
Soo-Jeong
SJ
Cho
Chan Gyoo
CG
Kim
Jae Kwan
JK
Jun
Kui Son
KS
Choi
Byung-Ho
BH
Nam
Jun Ho
JH
Lee
Keun Won
KW
Ryu
Young-Woo
YW
Kim
D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics / Q000473:pathology*; D013997:Time Factors