Abstract
The purpose of this study is to detect any factors affecting proper diagnosis in indirect photofluorography for gastric cancer screening. Gastric cancers detected in mass screening were categorized as either true positive (n=96) or false negative (n=28) cases. We compared the differences between the two groups with reference to the following items: locations, sizes of long diameter, depths of invasion, shape types, and histological types.
Lesions located on the lesser curvature in the U region, with a diameter shorter than 10 millimeters, with mucosal invasion, and of flat shape were strongly associated with incorrect check-up results. In fact, 76.9% of the false negative cases were not identified through indirect photofluorography. Especially in the U region, most cases including two advanced cancers were not recognized. The results demonstrate that the improvement of the photographic procedures is more important than the improvement of the photograph-reading capability in indirect photofluorography. In order to avoid missing gastric lesions, the use of a concentrated contrast material is required for revealing small abnormalities. And a fully worked-out rolling manipulation of patients during examination should also be considered, so as to obtain fine photofluorographies without leaving any blind spots.
