Abstract
In the individual screenings for stomach cancer in the Omiya district of Saitama City carried out between 1996 and 2005, 385 cases (0.29%) of stomach cancer were discovered, and 67.3% of these were in the early stage. These results are comparable to those attained in other districts where stomach cancer screening is actively performed, but it is a great concern that the rate of cases for which close examination was prescribed was high (14.8% in 2003). This is thought to be largely due to the way the need for close examination is determined in the Omiya district: i.e., all subjects underwent primary and secondary screening, and if they were found to require close examination in either screening, they underwent close examination. Considering that the appropriate rate of cases requiring close examination should be 10% or less, the following two measures were taken before starting the screenings in 2004: 1) the criteria for X-ray reading (grade classification) were established and the institutions were asked to give a grading together with the result of the X-ray reading, and 2) the mean rate of cases for which close examination was prescribed by the primary medical-care institutions was calculated and the institutions significantly exceeding the mean rate were asked to reconsider their X-ray readings. As a result of these measures, the mean rate of cases for which close examination was prescribed came down to 9.1% in 2005 and 8.1% in 2006, both within the target range of 10% or less. Since the cancer discovery rate was 0.31% in 2006, the rate of cases requiring close examination was appropriate without compromising the success of cancer detection.
