MANAGEMENT OF SCREENING ENDOSCOPY FOR POPULATION-BASED SCREENING FOR GASTRIC CANCER

Abstract

The purpose of cancer screening conducted as a public policy is to reduce the cancer death rate by carrying out examinations in asymptomatic persons for early detection and early treatment of the specified cancer. Since the death rate decreased after the endoscopy screening program was introduced, the endoscopy screening program in addition to barium X-ray examination has been permitted by the Ministry of Health, Labor and Welfare for use in population-based screening for gastric cancer in Japan from 2016. In the endoscopic examination performed as secondary prevention, precise management to secure a high quality of the examination is necessary. The final outcome of population-based screening for gastric cancer is a reduction in death rate, but it takes a long time to obtain the result. Therefore, evaluation by “an index of the technique and system” and “the process index” is necessary to monitor the accuracy of the screening program. In the endoscopy screening program in which many general physicians perform the screening, it is important to develop safety countermeasures against serious complications such as bleeding, shock, laceration, perforation, etc., and to establish a system in which the screening images are double-checked by the regional reading committee in order to maintain the quality of the screening program. This review article outlines the concepts of accuracy control that physicians who participate in the endoscopic screening program for gastric cancer as a public policy should know.