Background/Aims: Early gastric cancer (EGC) can be treated by endoscopic resection, which results in an excellent prognosis. Optimal screening intervals considering risk factors for gastric cancer have not been established. The aim of this study was to determine the maximum gastric cancer screening interval in terms of long-term survival. Methods: Curative resection was performed in 561 patients with gastric cancer who had completed a questionnaire on their previous history of screening tests and risk factors. The association between EGC detection rate and previous screening history was evaluated, and 5-year disease-free survival rates were compared between various screening intervals. Results: Multivariate analysis showed that intestinal metaplasia [hazard ratio (HR) 9.690, 95% confidence interval (CI) 5.896–15.927] and previous screening history (HR 0.077, 95% CI 0.048–0.125) were independent factors associated with advanced gastric cancer. In patients without intestinal metaplasia, there was no significant difference in the extent of gastric cancer progression and the 5-year disease-free survival rate between groups with screening intervals of less than 3 years. In patients with intestinal metaplasia, the cutoff screening interval for detection of EGC and disease-free survival was 2 years. Conclusion: The optimum screening interval for disease-free survival for gastric cancer in a normal population is 3 years, but a screening interval of 2 years should be used for patients with intestinal metaplasia in Korea.

Journal Section:
Original Paper
Keywords:
Screening, Survival, Metaplasia, Stomach neoplasm
1.
Terry MB, Gaudet MM, Gammon MD: The epidemiology of gastric cancer. Semin Radiat Oncol 2002;12:111–127.
[PubMed]
https://doi.org/10.1053%2Fsrao.30814
2.
Parker SL, Tong T, Bolden S, et al: Cancer statistics, 1997. CA Cancer J Clin 1997;47:5–27.
[PubMed]
https://doi.org/10.3322%2Fcanjclin.47.1.5
3.
Hohenberger P, Gretschel S: Gastric cancer. Lancet 2003;362:305–315.
[PubMed]
https://doi.org/10.1016%2FS0140-6736%2803%2913975-X
4.
Wayman J, Forman D, Griffin SM: Monitoring the changing pattern of esophago-gastric cancer: data from a UK regional cancer registry. Cancer Causes Control 2001;12:943–949.
[PubMed]
https://doi.org/10.1023%2FA%3A1013756531219
5.
Green PH, O’Toole KM, Slonim D, et al: Increasing incidence and excellent survival of patients with early gastric cancer: experience in a United States medical center. Am J Med 1988;85:658–661.
[PubMed]
https://doi.org/10.1016%2FS0002-9343%2888%2980238-9
6.
Hisamichi S, Sugawara N, Fukao A: Effectiveness of gastric mass screening in Japan. Cancer Detect Prev 1988;11:323–329.
[PubMed]
7.
Mizoue T, Yoshimura T, Tokui N, et al: Prospective study of screening for stomach cancer in Japan. Int J Cancer 2003;106:103–107.
[PubMed]
https://doi.org/10.1002%2Fijc.11183
8.
Howson CP, Hiyama T, Wynder EL: The decline in gastric cancer: epidemiology of an unplanned triumph. Epidemiol Rev 1986;8:1–27.
[PubMed]
9.
Carter KJ, Schaffer HA, Ritchie WP Jr: Early gastric cancer. Ann Surg 1984;199:604–609.
[PubMed]
https://doi.org/10.1097%2F00000658-198405000-00016
10.
Everett SM, Axon AT: Early gastric cancer in Europe. Gut 1997;41:142–150.
[PubMed]
https://doi.org/10.1136%2Fgut.41.2.142
11.
Fukao A, Tsubono Y, Tsuji I, et al: The evaluation of screening for gastric cancer in Miyagi Prefecture, Japan: a population-based case-control study. Int J Cancer 1995;60:45–48.
[PubMed]
https://doi.org/10.1002%2Fijc.2910600106
12.
Hisamichi S, Sugawara N: Mass screening for gastric cancer by X-ray examination. Jpn J Clin Oncol 1984;14:211–223.
[PubMed]
13.
Oshima A, Hirata N, Ubukata T, et al: Evaluation of a mass screening program for stomach cancer with a case-control study design. Int J Cancer 1986;38:829–833.
[PubMed]
https://doi.org/10.1002%2Fijc.2910380608
14.
Abe Y, Mitsushima T, Nagatani K, et al: Epidemiological evaluation of the protective effect for dying of stomach cancer by screening programme for stomach cancer with applying a method of case-control study – a study of an efficient screening programme for stomach cancer (in Japanese). Nippon Shokakibyo Gakkai Zasshi 1995;92:836–845.
[PubMed]
15.
Mori Y, Arita T, Shimoda K, et al: Effect of periodic endoscopy for gastric cancer on early detection and improvement of survival. Gastric Cancer 2001;4:132–136.
[PubMed]
https://doi.org/10.1007%2FPL00011735
16.
National cancer control programs in Korea. J Korean Med Sci 2007;22(suppl):S3–S4.
[PubMed]
17.
Cassaro M, Rugge M, Gutierrez O, et al: Topographic patterns of intestinal metaplasia and gastric cancer. Am J Gastroenterol 2000;95:1431–1438.
[PubMed]
https://doi.org/10.1111%2Fj.1572-0241.2000.02074.x
18.
Shiratori Y, Nakagawa S, Kikuchi A, et al: Significance of a gastric mass screening survey. Am J Gastroenterol 1985;80:831–834.
[PubMed]
19.
Nam SY, Choi IJ, Park KW, et al: Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees. Eur J Gastroenterol Hepatol 2009;21:855–860.
[PubMed]
https://doi.org/10.1097%2FMEG.0b013e328318ed42
20.
Yatsuya H, Toyoshima H, Mizoue T, et al: Family history and the risk of stomach cancer death in Japan: differences by age and gender. Int J Cancer 2002;97:688–694.
[PubMed]
https://doi.org/10.1002%2Fijc.10101
21.
Akamatsu N, Ide M, Ueda Y, et al: A population survey on a mass screening program for gastric cancer. 1. Population characteristics related to examination rates for the screening program (in Japanese). J UOEH 1986;8:177–183.
[PubMed]
22.
de Vries AC, Haringsma J, de Vries RA, et al: The use of clinical, histologic, and serologic parameters to predict the intragastric extent of intestinal metaplasia: a recommendation for routine practice. Gastrointest Endosc 2009;70:18–25.
[PubMed]
https://doi.org/10.1016%2Fj.gie.2008.08.041
23.
Correa P, Piazuelo MB, Wilson KT: Pathology of gastric intestinal metaplasia: clinical implications. Am J Gastroenterol 2010;105:493–498.
[PubMed]
https://doi.org/10.1038%2Fajg.2009.728
© 2011 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2011
You do not currently have access to this content.