Effect of endoscopy screening on stage at gastric cancer diagnosis: results of the National Cancer Screening Programme in Korea

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Authors: K S Choi ; J K Jun ; M Suh ; B Park ; D K Noh ; S H Song ; K W Jung ; H-Y Lee ; I J Choi ; E-C Park

MeSH: Adult ; Aged ; Aged, 80 and over ; Early Detection of Cancer/methods* ; Endoscopy, Gastrointestinal* ; Female ; Humans ; Male ; Mass Screening/methods ; Middle Aged ; Neoplasm Staging ; Program Evaluation ; Republic of Korea ; Stomach Neoplasms/pathology*

Abstract: BACKGROUND: Although gastric cancer screening is common among countries with a high prevalence of gastric cancer, there is little data to support the effectiveness of this screening. This study was designed to determine the differences in stage at diagnosis of gastric cancer according to the screening history and screening method (upper gastrointestinal series (UGIS) vs endoscopy).

METHODS: The study population was derived from the National Cancer Screening Programme (NCSP), a nationwide organised screening programme in Korea. The study cohort consisted of 19 168 gastric cancer patients who had been diagnosed in 2007 and who were invited to undergo gastric cancer screening via the NCSP between 2002 and 2007.

RESULTS: Compared with never-screened patients, the odds ratios for being diagnosed with localised gastric cancer in endoscopy-screened patients and UGIS-screened patients were 2.10 (95% CI=1.90-2.33) and 1.24 (95% CI=1.13-1.36), respectively.

CONCLUSIONS: Screening by endoscopy was more strongly associated with a diagnosis of localised stage gastric cancer compared with screening by UGIS.