Abstract
Objective: The effectiveness of endoscopic screening for gastric cancer was evaluated through comparison with X-ray screening which has been proved to be effective in reducing gastric cancer deaths.
Methods: We compared results for 8,807 participants examined by endoscopy in medical check-up from 1993 to 1999 and 36,876 participants examined using indirect X-rays in 1995.
Results: Gastric cancer and early cancer detection rates, and five year survival rates were 0.14%, 68.6% and 78.4%, respectively for X-ray screening and 0.34%, 93.9% and 97.0% for endoscopic screening, respectively, so the rates for the latter were higher. Subjects who were not diagnosed as having gastric cancer in the 2 screenings were referred to the Fukui Cancer Registry which is considered to be the most accurate population based cancer registry in Japan. There were 2 deaths due to gastric cancer in patients who underwent endoscopic screening and 41 for X-ray screening. The relative risk of gastric cancer death in the endoscopic screening group was 0.2042 as compared to the X-ray screening group.
Conclusions: We found a statistical difference in gastric cancer deaths between persons undergoing endoscopic screening and those having X-ray screening and our findings suggest that endoscopic screening would decrease gastric cancer deaths when used in health check-up.
