In the mass screening of stomach cancer at our center, double contrast radiography with highdensity barium (new technique) has been performed since March 2000. The rate of individuals requiring further examinations was reduced in the first year of introducing the new technique, raising the positive predictive value and rate of early cancer, but there was no change in the cancer detection rate (already reported). As a result of technicians confirming barium adhesion during radiography and by carrying out a qualitative diagnosis of benignity/malignancy in the image interpretation for the purpose of further improving the accuracy of gastric mass screening, the rate of those requiring further examinations was further reduced to 6.24%, and the cancer detection rate and positive predictive value rose to 0.28% and 5.48% respectively, which are approximately 1.75 and 2.9 times higher compared to conventional methods. Furthermore, in the study of an annual screening of detected cancer, the rate of early cancer by the new technique was 90.9%, and over half of those cases had the invasion depth of m.
The new technique enhances gastric mass screening accuracy by improving the radiography and image interpretation.

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In order to identify various existing problems associated with the gastroenterological examinations of advanced-age people and to establish the direction of future establishment of gastroenterological examinations, we have conducted a comparative study on the screening results obtained through a one-day complete physical examination of 100, 199 people, who have been subjected to gastroenterological screening at Kagoshima-ken Kohseiren Medical Health Care Center during the past 10 years. We have studied the results of the screening, comparing those of the advanced-age group (according to our definition, people 70 years of age and older) with those of the control group of juvenile- and middle-aged subjects. The advanced-age group constituted 5.1% of the subjects screened. The screening procedures consisted of gastrofluororadiography, immunochemical tests for occult blood in feces, and abdominal ultrasonography.
Our study has shown the following results:
(1) Screening: It took a longer time to apply gastrofluororadiography to advanced-age subjects, thus resulting in a less and less efficient performance of screening with advancing age. No particular problems were observed during intestinal screening. However, there was a noticeable tendency toward insufficient imaging quality in numerous cases of ultrasonography.
(2) Thorough examination: Detailed examination of the stomach did not yield any particular findings. There were many advanced-age subjects on whom total colonoscopy was impossible to perform. Regarding ultrasonography, its accuracy in thorough examinations is still subject to significant doubts.
However, despite such problems and difficulties, the effectiveness of gastroenterological screenings has improved over time.
In conclusion, we will positively promote the application of gastroenterological examinations to advanced-age people, with full concern for their comfort, and will seek to improve our skills in this regard.

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