Impact of endoscopic screening on mortality reduction from gastric cancer.
OBJECTIVE
To investigate mortality reduction from gastric cancer based on the results of endoscopic screening.


METHODS
The study population consisted of participants of gastric cancer screening by endoscopy, regular radiography, and photofluorography at Niigata city in 2005. The observed numbers of cumulative deaths from gastric cancers and other cancers were accumulated by linkage with the Niigata Prefectural Cancer Registry. The standardized mortality ratio (SMR) of gastric cancer and other cancer deaths in each screening group was calculated by applying the mortality rate of the reference population.


RESULTS
Based on the results calculated from the mortality rate of the population of Niigata city, the SMRs of gastric cancer death were 0.43 (95%CI: 0.30-0.57) for the endoscopic screening group, 0.68 (95%CI: 0.55-0.79) for the regular radiographic screening group, and 0.85 (95%CI: 0.71-0.94) for the photofluorography screening group. The mortality reduction from gastric cancer was higher in the endoscopic screening group than in the regular radiographic screening group despite the nearly equal mortality rates of all cancers except gastric cancer.


CONCLUSIONS
The 57% mortality reduction from gastric cancer might indicate the effectiveness of endoscopic screening for gastric cancer. Further studies and prudent interpretation of results are needed.
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan.
Chisato
C
Hamashima
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan.
Kazuei
K
Ogoshi
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan.
Rintarou
R
Narisawa
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan.
Tomoki
T
Kishi
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan.
Toshiyuki
T
Kato
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan.
Kazutaka
K
Fujita
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan.
Masatoshi
M
Sano
Chisato Hamashima, Cancer Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo 104-0045, Japan.
Satoshi
S
Tsukioka
D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005773:Gastroscopy; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D012042:Registries; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology* / Q000517:prevention & control; D013997:Time Factors
Gastric cancer screening; Mortality; Standardized mortality ratio; Upper gastrointestinal endoscopy; Upper gastrointestinal radiography