The optimal screening interval for gastric cancer using esophago-gastro-duodenoscopy in Japan

BMC Gastroenterology

Research Article

Daiki Kobayashi¹  Osamu Takahashi¹  Hiroko Arioka¹  Tsuguya Fukui¹ 

[1] Division of General Internal Medicine, Department of Internal Medicine, St. Luke’s International Hospital, Tokyo, Japan;

关键词: Gastric Cancer;    Endoscopic Submucosal Dissection;    Generalize Estimate Equation;    Atrophic Gastritis;    Malt Lymphoma;   

DOI  :  10.1186/1471-230X-12-144

 received in 2012-03-31, accepted in 2012-10-11,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundGastric cancer is one of the most significant diseases, and esophago-gastro-duodenoscopy (EGD) is one of screening methods for gastric cancer. This study was conducted to identify the optimal screening interval for gastric cancer using EGD in healthy adults.MethodsA retrospective cohort study was conducted on 3,723 healthy participants without a known diagnosis of gastric cancer at baseline from January 2005 to December 2010. Participants underwent annual health screenings, including EGD, at the Center for Preventive Medicine at St Luke’s International Hospital, a community teaching hospital in Japan. Participants with cytological abnormalities underwent further examination. A generalized estimating equation (GEE) was used to analyze the longitudinal data. We decided 0.5% of incidence of gastric cancer as a cutoff point for interval.ResultsThe mean age (SD) of the participants was 55 (11) years, and 1,879 (50.5%) were male. During the study period, gastric cancer was detected in 35 participants. However, the incidence varied based on their ages. In the age groups <40, 40–49, 50–59, 60–69 and ≥70 years old, the 5-year cumulative incidences (95%CI) of gastric cancer were 0% (0-0%), 0.3% (0.1-1.0%), 1.0% (0.5-1.8%), 1.4% (0.8-2.4%) and 1.9% (0.8-3.8%), respectively. The odds ratios of the incidence of gastric cancer per year, which were evaluated using GEE models for the age groups 40–49, 50–59, 60–69 and ≥70 years old, were 1.51 (95%CI: 0.91-2.49), 1.94 (95%CI: 1.31-2.86), 1.59 (95%CI: 1.23-2.06) and 1.46 (95%CI: 1.06-2.02), respectively.ConclusionsA screening for gastric cancer using EGD may be appropriate annually for healthy people over 70 years old, every two or three years for people 60–69 years old and every four years for people 50–59 years old. People younger than 50 years old may only need repeat screenings every five years or more.

【 授权许可】

CC BY   
© Kobayashi et al.; licensee BioMed Central Ltd. 2012