2025 Volume 63 Issue 3 Pages 337-356
It has been more than 60 years since gastric cancer screening began in Japan. Currently, two types of gastric cancer screening, gastric X-ray and gastric endoscopy, which have been scientifically proven to reduce the mortality of gastric cancer, are available as population-based screening for gastric cancer. In implementing population-based screening for gastric cancer, the Japanese government requires the development of a screening implementation system and accuracy control based on the Ministry of Health, Labour and Welfare guidelines, and the manuals for gastric X-ray and gastric endoscopic screening developed by Japanese Society of Gastrointestinal Cancer Screening have contributed greatly to the creation and standardization of an accuracy control system for gastric cancer screening. However, gastric X-ray and gastrointestinal endoscopic screening each have their own specific problems in terms of accuracy management, and it is difficult to properly manage the two modalities. While both morbidity and mortality rates of gastric cancer are on the decrease, the conventional gastric cancer screening system is becoming inefficient. Innovations such as risk-stratified screening that takes into account Helicobacter pylori infection status (a risk factor for gastric cancer), promotion of digital transformation, and use of artificial intelligence are eagerly awaited.
