The Japanese guidelines for gastric cancer screening
The Japanese guidelines for gastric cancer screening
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DOI：
10.1093/jjco/hyn017
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发表时间：
2008-04-01
影响因子：
2.4
通讯作者：
Sobue, Tomotaka
中科院分区：
文献类型：
--
作者：
Hamashima, Chisato;Shibuya, Daisuke;Sobue, Tomotaka
背景：胃癌是日本癌症死亡的主要原因。2004年，胃癌死亡人数为50 562人，占癌症死亡总人数的15.8%。自1983年以来，根据《老年人保健服务法》，在全国范围内对所有40岁及以上的居民进行胃癌筛查。研究方法：结果：评价了4种胃癌筛查方法：荧光透视法、内镜检查法、血清胃蛋白酶原检测法和幽门螺杆菌抗体检测法。根据涉及关键问题的分析框架，使用MEDLINE、日本医学研究数据库等方法，选择1985年1月至2005年2月发表的1715篇文章。系统性文献综述后，10篇文献被确定为直接证据，49篇文献被确定为间接证据。评估胃癌死亡率降低的研究包括5项病例对照研究和2项放射学筛查队列研究。在利与弊平衡的基础上，提出了基于人群和机会性筛查的建议。两种筛查方案均推荐使用荧光照相术进行胃癌筛查。其他方法由于证据不足，不推荐用于人群筛查。结论：胃癌筛查指南是在既往建立的方法基础上制定的。在日本，推荐使用荧光照相术进行胃癌筛查，用于人群和机会性筛查。
Background: Gastric cancer is the leading cause of death from cancer in Japan. In 2004, there were 50 562 deaths from gastric cancer; they accounted for 15.8% of the total number of cancer deaths. Since 1983, under the Health Service Law for the Aged, gastric cancer screening has been conducted nationwide for all residents aged 40 years and over. Methods: On the basis of the standardized method developed for the Japanese Guidelines for Cancer Screening, the efficacies of various methods for gastric cancer screening were evaluated and the guideline was developed.Results: Four methods for gastric cancer screening were evaluated: photofluorography, endoscopy, serum pepsinogen testing and Helicobacter pylori antibody testing. On the basis of the analytic framework involving key questions, 1715 articles, published from January 1985 to February 2005, were selected using MEDLINE, the Japanese Medical Research Database and other methods. After the systematic literature review, 10 articles were identified as direct evidence and 49 articles as indirect evidence. The studies that evaluated mortality reduction from gastric cancer included five case-control and two cohort studies for radiographic screening. On the basis of the balance of benefits and harms, the recommendations for population-based and opportunistic screening were formulated. Gastric cancer screening using photofluorography was recommended for both screening programs. The other methods were not recommended for population-based screening due to insufficient evidence.Conclusions: The guideline for gastric cancer screening guideline was developed based on the previously established method. Gastric cancer screening using photofluorography is recommended for population-based and opportunistic screening in Japan.