Inaba S, Hirayama H, Nagata C, Kurisu Y, Takatsuka N, Kawakami N, Shimizu H
Department of Public Health, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu, 500-8705, Japan.
Prev Med. 1999 Aug;29(2):102-6. doi: 10.1006/pmed.1999.0507.
Systematic population-based screening for gastric cancer is widely spread in Japan. However, the case-control study method has been the main method used to evaluate the effectiveness of the screen ing to reduce gastric cancer mortality in Japan.
This article presents a population-based cohort study. A questionnaire about lifestyles and dietary habits was distributed to 36,990 residents in a city of Japan. The response rate to the questionnaire was 92.0%. After ineligible responders had been excluded, 24,134 subjects were classified into screened and un screened groups according to their self-reports of participation in the screening the previous year. We followed them up for 40 months and linked resident death records in the city. We compared mortality from gastric cancer and all other causes between the groups by us ing the Cox proportional hazard model.
The follow-up period was 78,156.6 person-years from September 1992 to December 1995. The multivariate relative risks for gastric cancer death of the screened group in comparison with the unscreened group were 0.72 (95% CI 0.31-1.66) among males and 1.46 (95% CI 0.43-4.90) among females.
Although our data are preliminary, we were unable to demonstrate a large contribution of the present screening program to decreasing gastric cancer mortality. Further follow-up is needed to in crease the precision.
在日本，基于人群的胃癌系统筛查广泛开展。然而，病例对照研究方法一直是日本用于评估筛查降低胃癌死亡率有效性的主要方法。
本文介绍了一项基于人群的队列研究。向日本一个城市的36990名居民发放了关于生活方式和饮食习惯的问卷。问卷的回复率为92.0%。排除不符合条件的回复者后，根据他们自己报告的前一年参与筛查的情况，将24134名受试者分为筛查组和未筛查组。我们对他们进行了40个月的随访，并与该城市的居民死亡记录进行关联。我们使用Cox比例风险模型比较了两组之间的胃癌死亡率和所有其他原因导致的死亡率。
从1992年9月到1995年12月，随访期为78156.6人年。与未筛查组相比，筛查组男性胃癌死亡的多变量相对风险为0.72（95%CI 0.31 - 1.66），女性为1.46（95%CI 0.43 - 4.90）。
尽管我们的数据是初步的，但我们无法证明目前的筛查计划对降低胃癌死亡率有很大贡献。需要进一步随访以提高精确度。
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