Sensitivity of endoscopic screening for gastric cancer by the incidence method
Sensitivity of endoscopic screening for gastric cancer by the incidence method
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DOI：
10.1002/ijc.28065
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发表时间：
2013-08-01
影响因子：
6.4
通讯作者：
Kishimoto, Takuji
中科院分区：
文献类型：
--
作者：
Hamashima, Chisato;Okamoto, Mikizo;Kishimoto, Takuji
虽然在日本已经进行了胃癌的放射线筛查，但由于其高检出率，预计内窥镜检查将成为一种新的筛查方法。根据日本社区筛查结果，采用检测法和发病率法计算内镜和放射学筛查的敏感性。从2002年4月到2007年3月，在日本约纳戈，有56，676例胃癌筛查使用内窥镜和放射线检查。目标年龄组为40至79岁。基于与鸟取癌症登记处链接的筛查数据库，对筛查检测到的癌症和间隔癌症进行了研究。所有在阴性筛查后1年内诊断的胃癌都被认为是间隔癌。根据筛查史，分为患病率筛查和发病率筛查。患病率筛查包括7，388例内镜筛查和5，410例放射学筛查，而发病率筛查包括18，021例内镜筛查和11，417例放射学筛查。通过发病率方法计算的患病率筛查灵敏度，内镜筛查为0.886（95%置信区间[CI]=0.6980.976），放射学筛查为0.831（95% CI=0.5860.964）;然而，差异不显著（p=0.626）。通过发病率方法计算的发病率筛查灵敏度，内窥镜筛查为0.954（95%CI =0.8420.994），放射学筛查为0.855（95%CI =0.6370.970）（p=0.177）。在两轮筛查中，内镜筛查胃癌的敏感性均高于采用发病率法进行的放射学筛查。然而，需要进一步的研究来评估死亡率的降低和估计胃癌内镜筛查的过度诊断。
Although radiographic screening for gastric cancer has been conducted in Japan, it is anticipated that endoscopy will become a new screening method because of its high detection rate. The sensitivities of endoscopic and radiographic screening were calculated by the detection method and the incidence method based on the results of community-based screening in Japan. There were 56,676 screenings for gastric cancer using endoscopy and radiography from April 2002 to March 2007 in Yonago, Japan. The target age group was from 40 to 79 years. Screen-detected and interval cancers were investigated based on a screening database linked to the Tottori Cancer Registry. All gastric cancers diagnosed within 1 year after a negative screen were considered interval cancers. Based on the screening history, these were divided into prevalence screening and incidence screening. Prevalence screenings included 7,388 for endoscopic screening and 5,410 for radiographic screening, whereas incidence screenings included 18,021 for endoscopic screening and 11,417 for radiographic screening. The sensitivity of prevalence screening calculated by the incidence method was 0.886 (95% confidence interval [CI]=0.6980.976) for endoscopic screening and 0.831 (95% CI=0.5860.964) for radiographic screening; however, the difference was not significant (p=0.626). The sensitivity of incidence screening calculated by the incidence method was 0.954 (95% CI=0.8420.994) for endoscopic screening and 0.855 (95% CI=0.6370.970) for radiographic screening (p=0.177). Endoscopic screening for gastric cancer had a higher sensitivity than radiographic screening by the incidence method in both screening rounds. However, further study is needed to evaluate mortality reduction and to estimate overdiagnosis with endoscopic screening for gastric cancer.