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

Abstract

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.

Detection of secondary upper gastrointestinal tract cancer during follow‐up esophagogastroduodenoscopy after gastrectomy for gastric cancer

“…One study on EGD screening for the general Japanese population showed a 0.8% overall 5‐year cumulative incidence rate of gastric cancer, 17 and the present study indicated relatively higher incidence rates of remnant gastric cancer after gastrectomy. Our analyses identified a Brinkman index ≥ 600, proximal gastrectomy, and tumor size ≥ 30 mm as risk factors for remnant gastric cancer.…”

Failure of Helicobacter pylori eradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer in 283 patients

“…In general, increased age is an important risk factor for development of gastric cancer. Over 50 years old, the risk for incidence of gastric cancer is increased approximately two times and cumulative incidence of gastric cancer is increased with increased age . Yuji and colleagues reported that the risk of metachronous gastric cancer incidence was increased in the proportion of more than 5‐year follow‐up duration, regardless of the presence of H. pylori .…”

Health Economics Evaluation of a Gastric Cancer Early Detection and Treatment Program in China

“…Studies of gastric cancer screening time interval, Korea research (Kim et al, 2000) proposals for 1-5 years, the optimal time interval should be less than 3 years; Singapore (Dan et al, 2006) recommends every two years for a screening for gastric cancer; Japanese people aged 60-69 is recommended once every 2 to 3 years, and 50 to 59, once every four years, less than 50, but once every five years or more (Kobayashi et al, 2012). No gastric cancer screening interval research of our country, it can be used as our further research.…”