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Prospective study of screening for stomach cancer in Japan
Author(s) -
Mizoue Tetsuya,
Yoshimura Takesumi,
Tokui Noritaka,
Hoshiyama Yoshiharu,
Yatsuya Hiroshi,
Sakata Kiyomi,
Kondo Takaaki,
Kikuchi Shogo,
Toyoshima Hideaki,
Hayakawa Norihiko,
Tamakoshi Akiko,
Ohno Yoshiyuki,
Fujino Yoshihisa,
Kaneko Satoshi
Publication year - 2003
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.11183
Subject(s) - stomach cancer , stomach , medicine , relative risk , hazard ratio , confounding , cancer , cohort study , confidence interval , proportional hazards model , prospective cohort study , gastroenterology
Abstract Although screening for stomach cancer is a widespread community service in Japan, the benefits of the screening program remain unclear. Our study investigated prospectively the relation between participation in stomach‐cancer screening during the past 12 months and subsequent deaths. Data was derived from the Japan Collaborative Cohort Study, in which 480 stomach‐cancer deaths were identified during an 8‐year follow‐up period. Cox proportional hazard regression was used to estimate the relative risk of death from stomach cancer and that from other causes while adjusting for potential confounding factors. In men, screening participation was associated significantly with a reduced risk of death from stomach cancer (relative risk [RR] = 0.54; 95% confidence interval [CI] = 0.41–0.70). The extent of the risk reduction was greater than potential health selection (for deaths other than stomach, RR = 0.71). The adjustment for potential confounding variables, however, attenuated the difference in risk of death (stomach cancer, RR = 0.65; other causes, RR = 0.71). In women, the magnitude of the association between screening participation and death from stomach cancer (RR = 0.74; 95% CI = 0.52–1.07) was equal to that for deaths from non‐stomach cancers (RR = 0.74). Subgroup analysis showed that women with a parental history of stomach cancer had a reduced risk of death from stomach cancer associated with screening (RR = 0.32; 95% CI = 0.12–0.87). The present results underline the potential for selection bias in observational studies, and thus it remains an open question whether screening for stomach cancer is effective. © 2003 Wiley‐Liss, Inc.