[Comparison of two gastric cancer screening schemes in a high-risk population].
OBJECTIVE
To evaluate the effects of two gastric cancer screening schemes for early detection of gastric cancer in a high-risk population.


METHODS
A cluster random sampling method was used to select local residents aged 40-69 years from Linqu County, Shandong Province. "Serum pepsinogen initial screening combined with further endoscopic examination (PG scheme)" and "direct endoscopic examination (endoscopy scheme)" were conducted. The associations between screening schemes and detection rates of gastric cancer, and early gastric cancer/high-grade intraepithelial neoplasia were evaluated by unconditional logistic regression analysis.


RESULTS
Overall, 3654 and 2290 participants completed PG and endoscopy schemes, respectively. A total of 11 (0.30%) cases of gastric cancer and 10 (0.27%) cases of high-grade intraepithelial neoplasia were detected by PG scheme, of which 7 (0.19%) cases were early gastric cancer. While, 19 (0.83%) cases of gastric cancer and 10 (0.44%) cases of high-grade intraepithelial neoplasia were detected by endoscopy scheme, with 12 (0.52%) cases of early gastric cancer. Compared with the PG scheme, the endoscopy scheme had a significantly higher detection rates of gastric cancer (OR = 2.83, 95%CI 1.34-5.98), and early gastric cancer/high-grade intraepithelial neoplasia (OR = 2.12, 95%CI 1.12-4.02).


CONCLUSIONS
The endoscopy scheme is more effective in the detection of gastric cancer in a high-risk population, particularly for early gastric cancer/high-grade intraepithelial neoplasia than the PG scheme.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital & Institute, Beijing 100142,China.
Yan-li
YL
Lü
Yi
Y
Li
Guang-shun
GS
Liu
Qi
Q
Wu
Wei-dong
WD
Liu
Shi-jie
SJ
Li
Chang-qi
CQ
Cao
Xiu-zhen
XZ
Wu
Dong-mei
DM
Liu
Lei
L
Zhang
Lan-fu
LF
Zhang
Jun-ling
JL
Ma
Kai-feng
KF
Pan
Lian
L
Zhang
Wei-cheng
WC
You
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis*; D002278:Carcinoma in Situ / Q000097:blood / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis*
D020116:Pepsinogen A