2026 Volume 64 Issue 3 Pages 524-536
Hachioji City in Tokyo introduced endoscopic gastric cancer screening in fiscal year (FY) 2018. After being used in conjunction with X-ray screening, X-ray screening was discontinued in FY 2021, the 4th year. The number of patients undergoing gastric cancer screening increased from 7,555 in FY 2017, when only X-ray screening was used, to 8,579 in FY 2022, when only endoscopy was used. During the period when both methods were used, 95% of eligible patients opted for endoscopic screening, indicating that the introduction of endoscopy contributed to an increased screening uptake rate. Over the 5-year period, a total of 37,558 patients underwent endoscopic screening for gastric cancer, leading to the detection of 151 cases, including 122 early-stage cancers (87 of which were intramucosal). Additionally, the rates for the process indices were 100%, 4.9%, 5.2%, 0.40%, and 7.7% for detailed examinationuptake rate, biopsy uptake rate, biopsy requirement rate, cancer detection rate, and positive test adequacy rate, respectively. These data compare favorably with national 5-year data spanning from FY 2018 to 2022 as well as the overall Tokyo data. We believe that establishing a high-accuracy quality control system in cooperation with the government, particularly the independently implemented dual-reading system by the Hachioji City Medical Association, will contribute to decreasing the mortality rate attributed to gastric cancer, which will benefit citizens.
This report describes the 5-year history of gastric cancer endoscopic screening introduced by Hachioji City and the Hachioji City Medical Association. It includes the background of its introduction, implementation methods, track record, and efforts to maintain and improve the quality control system.
