2020 Volume 58 Issue 4 Pages 342-352
Since 2014, endoscopic gastric cancer screening has been primarily recommended in Japan for the diagnosis of gastric cancer. However, the comparison of efficacy and acceptability of transnasal and transoral endoscopy has generated controversial results. We retrospectively investigated 18,780 subjects who underwent screening endoscopy at our hospital from April 2008 to December 2017. We evaluated the characteristics of cancers detected in the study population and used a questionnaire to compare the efficacy and acceptability of transnasal and transoral endoscopies. In our study, 28.3% of the patients underwent transnasal endoscopy. The gastric cancer detection rate was 0.14%, and there was an early detection of gastric cancer in 76.9% of patients. There was no significant difference between transnasal and transoral endoscopies regarding the cancer detection rate. The complication rates of transnasal and transoral endoscopies were 0.43% and 0.15%, respectively. The incident rate of transnasal endoscopy was significantly higher than that of transoral endoscopy; however, there were no serious complications. Epistaxis and oversedation were the most common complications associated with transnasal and transoral endoscopies, respectively. The results of the questionnaire revealed no significant intergroup difference in the patients' choice of an endoscopic procedure, if it were indicated in future. Subjects who chose transnasal endoscopy tended to choose the same technique, if they were presented with the choice of endoscopy in future. Transnasal endoscopy was useful in the mass endoscopic screening of gastric cancer. We conclude that transoral endoscopy would be acceptable for mass endoscopic screening if informed consent can be obtained from the patients and if adequate measures are adopted to prevent complications.
