Prevalence and prognosis of gastric cancer detected by screening in a large Japanese population: Data from a single institute over 30 years
Prevalence and prognosis of gastric cancer detected by screening in a large Japanese population: Data from a single institute over 30 years
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DOI：
10.1111/j.1440-1746.2007.04991.x
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发表时间：
2007-09-01
影响因子：
4.1
通讯作者：
Goto, Hidemi
中科院分区：
文献类型：
--
作者：
Miyahara, Ryoji;Niwa, Yasumasa;Goto, Hidemi
背景和目的：在日本，广泛进行荧光照相筛查检查以降低胃癌死亡率。这表明未来胃癌病例数可能会下降及其特征发生变化。本研究的目的是检验直接放射学作为一般健康筛查技术的有用性以及日本胃癌的历史变化。方法：本研究涉及 936 名胃癌患者，这些患者的癌症是 1970 年至 2000 年爱知县保健中心一般健康筛查的一部分，通过直接放射学检测到的。我们研究了胃癌的患病率、预后、两种癌症组织学类型之间的差异和历史变化。年龄调整后的癌症检出率略有下降。两种组织学类型比较，弥漫型癌病例相对增多。肠型癌在胃下部增加，而弥漫型癌在胃上部增加。肠型癌5年生存率为92.7%，弥漫型癌5年生存率为84.8%。当通过直接放射学检测时，弥漫型癌比肠型癌进一步进展；然而，由于弥漫型的检出率有所提高，因此弥漫型早期胃癌的比例显着增加，生存率也显着提高，从70.4%提高到90.5%。结论：日本胃癌的患病率一直在下降，但局限于胃上部的弥漫型癌的比例却在增加。
Background and Aim: In Japan, screening examination with photofluorography is widely performed to reduce the mortality due to gastric cancer. The possibility of a future decline in gastric cancer cases and changes in its characteristics is suggested. The aim of this study was to examine the usefulness of direct radiology as a general health screening technique and the historical changes of gastric cancer in Japan.Methods: This study involved 936 patients with gastric cancer whose carcinomas were detected by direct radiology as part of a general health screening at the Aichi Prefectural Center for Health Care from 1970 to 2000. We studied the prevalence of gastric carcinoma, its prognosis, differences between the two histological types of carcinoma and historical changes.Results: The age-adjusted cancer detection rate slightly decreased. Comparing two histological types, diffuse-type carcinoma cases relatively increased. Intestinal-type carcinomas increased in the lower portion of the stomach, whereas diffuse-type increased in the upper portion. The 5-year survival rate was 92.7% for intestinal-type carcinoma and 84.8% for diffuse-type. Diffuse-type carcinomas were further progressed than intestinal-type when detected by direct radiology; however, detection of diffuse-type improved, so the percentage of early gastric cancer of diffuse type significantly increased, and the survival rate significantly improved, from 70.4% to 90.5%.Conclusion:The prevalence of gastric cancer has been decreasing, but the proportion of diffuse-type carcinoma localized in the upper portion of the stomach has been increasing in Japan.