Abstract
Endoscopy for gastric cancer has been used for more than 20 years in Japan. However, it is not necessarily used for early examination, such as during x-ray medical check-up. To evaluate the contribution of esophagogastroduodenoendoscopy (EGD) to gastric cancer medical examination, we compared endoscopical and pathological diagnoses by dividing participants of this study into two groups: 1,346 ‘Ningen Dock’ (ND; medical check-up) subjects and 6,315 general practice (GP) patients, and the usefulness of EGD was shown. Gastric adenocarcinoma was detected in 0.7% (10 of 1,346 subjects; peak age = 60 years) of ND subjects and 3.8% (283 of 6,315 patients; male:female = 4.3%:2.8%, peak age = 70 years) of GP patients. Among the ten ND subjects (0.7%), the distribution of the diagnoses based on endoscopy results was 80% early cancer, 10% advanced cancer, and 10% noncancer. In contrast, in the GP group, only 51.7% showed detectable early cancer. In addition, the age at which cancer was detected was 10 years younger in the ND group than in the GP group. The percentage of patients in whom endoscopy was used for mass screening reached 9.1%. Also, in ND, the combined use of endoscopic diagnosis and biopsy diagnosis is important given the 10% noncancer cases. Therefore, for the early detection and treatment of gastric cancer, it is important to improve the EGD consultation rate by ND, which will contribute to the reduction in mortality rate.
