Kikuchi S, Inaba Y
Department of Hygiene, Juntendo University School of Medicine.
Nihon Koshu Eisei Zasshi. 1992 Jul;39(7):380-6.
In the mass-screening system for gastric cancer, subjects are primarily examined by contrasted indirect roentgenography and if secondary examination is diagnosed to be necessary, they are examined by contrasted direct roentgenography or gastric fiberscopy. Methods for increasing the efficiency of this system from the standpoint of cost-effectiveness were studied, and the basis for decision of whether or not serological examinations such as of serum pepsinogens and serum anti-Helicobacter-antibodies should be brought in to the system, and in what manner serological examinations should be brought in to the system if proven to be effective were examined. Problems found in the present practiced system and the proposed new system with serological examinations were repetition interval for examinations, selection of high-risk subjects and communication between subjects and the medical staff or among the members of the medical staff. Analysis by receiver operating characteristics curve should be included when serological examinations are indicated. In addition whether the mass-screening system for gastric cancer produces an actual reduction in death by gastric cancer should be confirmed after the system is made more efficient.
在胃癌大规模筛查系统中，主要通过对比间接X线造影对受试者进行检查，若诊断需要二次检查，则通过对比直接X线造影或胃纤维内镜检查。从成本效益的角度研究了提高该系统效率的方法，探讨了血清胃蛋白酶原和血清抗幽门螺杆菌抗体等血清学检查是否应纳入该系统以及若证明有效应以何种方式纳入该系统的决策依据。在现行系统和提议的包含血清学检查的新系统中发现的问题有检查的重复间隔、高危受试者的选择以及受试者与医务人员之间或医务人员之间的沟通。当需要进行血清学检查时，应包括通过受试者工作特征曲线进行分析。此外，在提高胃癌大规模筛查系统的效率后，应确认该系统是否能实际降低胃癌死亡率。
