title: Increase in Endoscopic and Laparoscopic Surgery Regarding the Therapeutic Approach of Gastric Cancer Detected by Cancer Screening in Saga Prefecture, Japan.
abstract: Objective Despite recent advances in endoscopic treatment and laparoscopic surgery for gastric cancers, an increase in the uptake of these therapeutic approaches has not yet been fully demonstrated. Therefore, the present study aimed to investigate the change in therapeutic approaches regarding the treatment of gastric cancers detected by cancer screening in Saga Prefecture, Japan between April 2002 and March 2011. Methods Gastric cancer screening by X-ray was performed on 311,074 subjects between April 2002 and March 2011. In total, 534 patients were thereafter diagnosed with gastric cancer. Eighteen subjects were excluded because precise details of their treatment were not available. To evaluate the changes in the therapeutic approach, the observation period was divided into three 3-year intervals: Period I: April 2002 to March 2005; Period II: April 2005 to March 2008; Period III: April 2008 to March 2011. Results The use of open laparotomy for the treatment of gastric cancer decreased, and laparoscopic surgery and endoscopic treatment increased markedly in a time-dependent manner. A 2.5-fold increase in endoscopic treatment, and a 18.4-fold increase in laparoscopic surgery were observed in Period III compared with Period I (after adjusting for age and tumor characteristics). Conclusion Endoscopic treatment and laparoscopic surgery for gastric cancer increased during the investigation period (2002-2011), although the tumor characteristics of the gastric cancers detected through cancer screening in Saga Prefecture, Japan did not show any changes.
authors.affiliation: Department of Internal Medicine, Saga Medical School, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Megumi
authors.initials: M
authors.lastname: Hara
authors.forename: Kayo
authors.initials: K
authors.lastname: Akutagawa
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamaguchi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Hidaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakata
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Masanobu
authors.initials: M
authors.lastname: Mizuguchi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Shimoda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Irie
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Noshiro
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer; D016099:Endoscopy, Gastrointestinal / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods / Q000639:trends*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy / Q000639:trends*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D013997:Time Factors