Open AccessGastric cancer screening of a high‐risk population in Japan using serum pepsinogen and barium digital radiography
Author(s) -
Ohata Hiroshi,
Oka Masashi,
Yanaoka Kimihiko,
Shimizu Yasuhito,
Mukoubayashi Chizu,
Mugitani Kouichi,
Iwane Masataka,
Nakamura Hideya,
Tamai Hideyuki,
Arii Kenji,
Nakata Hiroya,
Yoshimura Noriko,
Takeshita Tetsuya,
Miki Kazumasa,
Mohara Osamu,
Ichinose Masao
Publication year - 2005
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/j.1349-7006.2005.00098.x
Subject(s) - medicine , cancer , asymptomatic , cancer screening , population , screening test , gastroenterology , histology , oncology , radiology , pediatrics , environmental health
With the aim of developing more efficient gastric cancer screening programs for use in Japan, we studied a new screening program that combines serum pepsinogen (PG) testing and barium digital radiography (DR). A total of 17 647 middle‐aged male subjects underwent workplace screening over a 7‐year period using a combination of PG testing and DR. This program's effectiveness, as well as other characteristics of the program, was analyzed. Forty‐nine cases of gastric cancer were detected (comprising 88% early cancer cases). The detection rate was 0.28%, and the positive predictive value was 0.85%. The PG test detected 63.3% of cases, DR detected 69.4% of cases, and both tests were positive in 32.7% of cancer cases. The two methods were almost equally effective, and were considerably more effective than conventional screening using photofluorography. Each screening method detected a distinct gastric cancer subgroup; the PG test efficiently detected asymptomatic small early cancer with intestinal type histology, while DR was efficient at detecting cancers with depressed or ulcerated morphology and diffuse type histology. The cost for the detection of a single cancer was much less than that for conventional screening. In fact, it is possible to further reduce the cost of detecting a single cancer to a cost comparable to that of surgically resecting a single gastric cancer. Thus, it is probable that a highly efficient gastric cancer screening system can be implemented by combining the two screening methods. Such a screening program would be beneficial in a population at high risk for gastric cancer. ( Cancer Sci 2005; 96: 713 – 720)