title: Performance of different gastric cancer screening methods in Korea: a population-based study.
abstract: BACKGROUND
  There is a lack of agreement on which gastric cancer screening method is the most effective in the general population. The present study compared the relative performance of upper-gastrointestinal series (UGIS) and endoscopy screening for gastric cancer.
  
  
  METHODS
  A population-based study was conducted using the National Cancer Screening Program (NCSP) database. We analyzed data on 2,690,731 men and women in Korea who underwent either UGIS or endoscopy screening for gastric cancer between January 1, 2002 and December 31, 2005. Final gastric cancer diagnosis was ascertained through linkage with the Korean Central Cancer Registry. We calculated positivity rate, gastric cancer detection rate, interval cancer rate, sensitivity, specificity, and positive predictive value of UGIS and endoscopy screening.
  
  
  RESULTS
  The positivity rates for UGIS and endoscopy screening were 39.7 and 42.1 per 1,000 screenings, respectively. Gastric cancer detection rates were 0.68 and 2.61 per 1,000 screenings, respectively. In total, 2,067 interval cancers occurred within 1 year of a negative UGIS screening result (rate, 1.17/1,000) and 1,083 after a negative endoscopy screening result (rate, 1.17/1,000). The sensitivity of UGIS and endoscopy screening to detect gastric cancer was 36.7 and 69.0%, respectively, and specificity was 96.1 and 96.0%. The sensitivity of endoscopy screening to detect localized gastric cancer was 65.7%, which was statistically significantly higher than that of UGIS screening.
  
  
  CONCLUSIONS
  Overall, endoscopy performed better than UGIS in the NCSP for gastric cancer. Further evaluation of the impact of these screening methods should take into account the corresponding costs and reduction in mortality.
authors.affiliation: National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Kui Son
authors.initials: KS
authors.lastname: Choi
authors.forename: Jae Kwan
authors.initials: JK
authors.lastname: Jun
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
authors.forename: Sohee
authors.initials: S
authors.lastname: Park
authors.forename: Kyu Won
authors.initials: KW
authors.lastname: Jung
authors.forename: Mi Ah
authors.initials: MA
authors.lastname: Han
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Hoo-Yeon
authors.initials: HY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D041742:Upper Gastrointestinal Tract / Q000473:pathology