[in Japanese]

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Between April 2000 and March 2002, we compared the conventional gastric cancer screening technique (barium meal 145w/v%, small quantity of gas-producing powder) with our novel method that uses high-concentration barium meal (185w/v%) and a large quantity of gas-producing powder. The novel method was superior to the conventional technique based on the detection rate of gastric cancer and the standard detection rate for gastric cancer adjusted by the age and sex distribution of the candidates.
The detection rate of early gastric cancer in the upper part of gastric corpus by the novel technique was better, probably due to the excellent depiction of the gastric mucosa.
Although high-concentration barium tended to condense in the gastric juice, we concluded that it should be used for gastric cancer screening to improve the detection rate, particularly early gastric cancer in the upper part of the gastric corpus.

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The gastric cancer detection program for inhabitants of the Omiya District (formerly Omiya City) of Saitama City, which performs checkups on an individual basis, instead of as a group health screening, was started in 1996. Until 2001, 192 cases of gastric cancer were detected by this program, with the incidence being 0.30%. The diagnostic image of each inhabitant receiving this checkup was evaluated twice (primary and secondary reading). A unique feature of this program is that inhabitants suggested by either primary or secondary reading as requiring detailed examination receive the detailed examination. Inhabitants who were rated as requiring detailed examination under this program were divided into three groups: Group A (abnormalities found by both primary and secondary reading), Group B (abnormalities found by primary reading alone), and Group C (abnormalities found by secondary reading alone). The cases of gastric cancer detected in each group were analyzed. The number of cases diagnosed with gastric cancer in each group and its percentage among all cases of gastric cancer detected in the entire study population were 123 (64.1%) in Group A, 24 (12.5%) in Group B and 45 (23.4%) in Group C. The percentage of early gastric cancers among all gastric cancers was 52.8% in Group A, 87.5% in Group B and 64.4% in Group C. The percentage of inhabitants who were rated as requiring detailed examination was as high as 23.8% in the first year of this program but decreased to 16.7% six years later. Group B cases seem to greatly affect the success or failure of this health checkup program. 6We plan to continue this program and analyze additional data.

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We studied the utility of serum pepsinogen test (PG test) in combination with upper gastrointestinal series (UGIS) in comparison with upper gastrointestinal series alone for detection of stomach cancer in mass screening at Kansai Occupational Health Association. We adopted PG I ≤30 ng/ml and I/II ≤2.0 as the screening cut off levels in the PG test. Consequently, the rate of further examination increased to 9. 4% after PG test and UGIS were used together, and as this rate was less than 10%, it was considered acceptable. The detection rate of cancer (max 0. 09%) by PG test combined with UGIS was almost the same as that (max 0. 07%) of UGIS alone. There were some cases of early cancer registering PG test positive and UGIS negative, and on the other hand, some cases of advanced cancer were PG test negative and UGIS positive. Our findings suggested that PG test and UGIS screened different populations from each other. Therefore, the PG test was a useful method in screening for stomach cancer because it could detect early cancer not found by UGIS alone. Thus, we found that the PG test was useful as a complementary test for UGIS in mass screening.

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Our previous paper described how to implement efficient screening TCS (S-TCS) for invasive carcinoma 1). This report presents a reconsideration of how to implement efficient S-TCS, and the extension of the investigation period for another year. Of the 34,348 subjects who had undergone STCS for the first time at our center from 1992 through 1999, 1, 184 that were found to have invasive carcinoma were investigated. The results are as follows.(i) Implementing initial S-TCS for those suspected of colorectal cancer at 35 years of age or over seems efficient.(ii) Performing only a single S-TCS yields very hight screening effect.(iii) When m tumor or adenoma is detected at the initial screening, it is efficient to perform a second screening 3 years thereafter.(iv) When m tumor or adenoma is not detected at the initial screening, the second screening can wait until 5 years after the initial screeing.(v) A third S-TCS may not be necessary for some time.

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[in Japanese]

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