Screening for gastric cancer in Japan.
Screening for gastric cancer in Japan.
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DOI：
10.1007/pl00011692
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发表时间：
2000-08-04
期刊：
影响因子：
--
通讯作者：
Hisamichi, Shigeru
中科院分区：
文献类型：
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作者：
Tsubono, Yoshitaka;Hisamichi, Shigeru
日本于1960年开始使用荧光照相法进行胃癌的大规模筛查。目前，每年有600多万人接受筛查。荧光照相术的敏感性和特异性分别为70%-90%和80%-90%。筛查发现的癌症的5年生存率比非筛查诊断的病例高15%-30%。虽然没有随机对照试验的报道，但队列和病例对照研究通常显示，在筛选的受试者中，胃癌死亡率的风险降低。3项病例对照研究中，男性和女性曾筛查受试者与从未筛查受试者的总体比值比（95%置信区间）分别为0.39（0.29-0.52）和0.50（0.34-0.72）。大量证据表明，日本的荧光照相筛查计划可有效降低胃癌死亡率。血清胃蛋白酶原的测量最近引起了人们的注意，作为荧光照相术的替代方法，因为它成本低，操作简单。一些研究表明，这两种方法的准确度相当。然而，这些研究可能高估了血清胃蛋白酶原检测与荧光摄影相比的相对灵敏度，因为血清胃蛋白酶原检测是作为普遍筛查进行的，而荧光摄影是作为偶然筛查进行的。此外，没有研究直接检查血清胃蛋白酶原筛查是否降低胃癌死亡率。因此，目前还没有足够的证据来确定这一计划的好处。
In Japan, mass screening for gastric cancer with photofluorography was initiated in 1960. At present, over 6 million people are screened annually. The sensitivity and specificity of photofluorography are 70%-90% and 80%-90%, respectively. The 5-year survival rate is 15%-30% better in screen-detected cancers than in symptom-diagnosed cases. Although no randomized controlled trials have been reported, cohort and case-control studies generally showed a decreased risk of mortality from gastric cancer in the screened subjects. The summary odds ratio (95% confidence interval) of three case-control studies for ever screened versus never screened subjects was 0.39 (0.29-0.52) for men and 0.50 (0.34-0.72) for women. Substantial evidence indicates that the Japanese screening program with photofluorography is effective in reducing the mortality from gastric cancer. The measurement of serum pepsinogens has recently drawn attention as an alternative to photofluorography, given its lower cost and simplicity. Some studies have suggested a comparable accuracy for the two methods. However, these investigations may have overestimated the relative sensitivity of serum pepsinogen testing compared with photofluorography, because serum pepsinogen testing was conducted as prevalent screening, while photofluorography was done as incident screening. Furthermore, no studies have directly examined whether the screening with serum pepsinogens reduced gastric cancer mortality. Therefore, at present, evidence is insufficient to determine the benefit of this program.