Abstract
To review the criteria for image interpretation, we considered improving the accuracy of X-ray screening for gastric cancer.
In the individual X-ray screening for gastric cancer in the Omiya District of Saitama City, the degrees of background gastric mucosal atrophy and gastric folds of the greater curvature of the gastric body were examined for 110 patients diagnosed with gastric cancer since fiscal year 2005 and approximately 23% of patients with early stomach cancer were found to have severe mucosal atrophy in the gastric areas and no gastric folds in the greater curvature of the gastric body. Therefore, the criteria for image interpretation (diagnostic category) were revised in fiscal year 2012. According to the new criteria, patients with severe background mucosal atrophy in the gastric areas and no gastric folds in the greater curvature of the gastric body and patients with suspected nodular gastritis were classified as Category 3 by secondary image interpretation alone, and these patients were considered to require a thorough examination. As a result, 4 cases with gastric cancer were found in patients with severe atrophy, and the gastric cancer discovery rate increased from 0.15% to 0.19%, although this revision of the criteria for image interpretation increased the rate of patients who required a thorough examination by 0.84%. The new criteria that take into account the degree of background gastric mucosal atrophy were considered to be a possible contributor to improvement in the rate of early cancer detection from individual X-ray screening for gastric cancer.
