Effectiveness of endoscopic screening for gastric cancer: The Japan Public Health Center-based Prospective Study

被引:9
作者
Narii, Nobuhiro [1 ]
Sobue, Tomotaka [1 ]
Zha, Ling [1 ]
Kitamura, Tetsuhisa [1 ]
Iwasaki, Motoki [2 ,3 ]
Inoue, Manami [2 ,4 ]
Yamaji, Taiki [3 ]
Tsugane, Shoichiro [2 ,5 ]
Sawada, Norie [2 ]
机构
[1] Osaka Univ, Grad Sch Med, Dept Social & Environm Med, Osaka, Japan
[2] Natl Canc Ctr Inst Canc Control, Div Cohort Res, Tokyo, Japan
[3] Natl Canc Ctr Inst Canc Control, Div Epidemiol, Tokyo, Japan
[4] Natl Canc Ctr Inst Canc Control, Div Prevent, Tokyo, Japan
[5] Natl Inst Hlth & Nutr, Natl Inst Biomed Innovat, Hlth & Nutr, Tokyo, Japan
关键词
endoscopic screening; gastric cancer; population-based prospective cohort study; radiographic screening; MORTALITY REDUCTION; POPULATION; IMPACT;
D O I
10.1111/cas.15545
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Upper gastrointestinal endoscopy for gastric cancer screening has been implemented in Japan. However, its effectiveness for gastric cancer prevention has not been fully studied. We aimed to investigate the effectiveness of endoscopic screening to reduce mortality from gastric cancer. In a large prospective population-based cohort study including 80,272 participants, we compared the risk of mortality and incidence of gastric cancer among participants who underwent endoscopic or radiographic screening compared with those who did not undergo any screening using multivariable Cox proportional hazards models. In the 1,023,364 person-year observation period (median; 13.0 years), 1977 cases of gastric cancer were diagnosed, and 783 patients with gastric cancer died. In the endoscopic screening group, the mortality from gastric cancer and incidence of advanced gastric cancer were reduced by 61% (hazard ratio [HR] = 0.39 [95% CI: 0.30-0.51]) and 22% (HR = 0.78 [95% CI: 0.67-0.90]), respectively. The radiographic screening reduced the mortality from gastric cancer (HR = 0.63 [95% CI: 0.54-0.73]), but its effectiveness was lower than that of endoscopic screening. In conclusion, endoscopic screening reduced the incidence of advanced gastric cancer and mortality from gastric cancer in the Japanese population.
引用
收藏
页码:3922 / 3931
页数:10
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