Yuan Yuan
Tumor Etiology and Screening Department of Cancer Institute and General Surgery, The First Affiliated Hospital of China Medical University, Key Laboratory of Cancer Control in Liaoning Province, Shenyang 110001, China.
Zhonghua Zhong Liu Za Zhi. 2012 Jul;34(7):538-42. doi: 10.3760/cma.j.issn.0253-3766.2012.07.013.
To investigate the feasibility of gastric cancer screening for the susceptible population in the high-risk areas of China and to optimize the screening programme.
By using the two-round screening method i.e. serum pepsinogen test combined with gastric mucosa biopsy, large-scale population screening programs were carried out in Zhuanghe, Liaoning province. All adults or residents above 35 years old with a positive family history of gastric cancer or gastrointestinal symptoms were targeted.
Three large-scale population screenings were developed over the past 15 years. All together, 13078 participants accepted the two-round screening, and 108 gastric cancer cases were detected. Among them, the detection rate of early gastric cancer was 56.82%, 51.22% and 82.61%, respectively. The pathologically confirmed gastric cancer cases were immediately arranged to have early surgical treatment, and meanwhile, the follow-up files for the patients were established. With a consecutive and regular 10-year postoperative follow-up, the 5-year survival rate for these early gastric cancer patients reached 90.48%. Effectiveness and health economic evaluation confirmed that there are good specificity and sensitivity for the two round screening programs. It is cost-effective. As the primary screening method serum PG test can improve the screening examination rate and concentrate the gastric cancer risk populations.
It is feasible to develop the gastric cancer screening program among the susceptible population in high-risk areas in our country, and the two-round screening method is of practical value. Research for early detection of gastric cancer should be further enhanced, and multidisciplinary and multicenter cooperation should be organized. It is necessary to extend the implementation the gastric cancer screening and to further improve the early detection programme, in order to make a breakthrough based on the present practice.
探讨在中国胃癌高发地区对易感人群进行胃癌筛查的可行性，并优化筛查方案。
采用血清胃蛋白酶原检测联合胃黏膜活检的两轮筛查方法，在辽宁省庄河市开展大规模人群筛查项目。目标人群为所有35岁及以上有胃癌家族史阳性或有胃肠道症状的成年人或居民。
在过去15年中开展了三次大规模人群筛查。共有13078名参与者接受了两轮筛查，共检测出108例胃癌病例。其中，早期胃癌的检出率分别为56.82%、51.22%和82.61%。病理确诊的胃癌病例立即安排早期手术治疗，同时建立患者随访档案。经过连续10年的定期术后随访，这些早期胃癌患者的5年生存率达到90.48%。有效性和卫生经济学评价证实，两轮筛查方案具有良好的特异性和敏感性。具有成本效益。作为初筛方法，血清PG检测可提高筛查检出率，集中胃癌高危人群。
在我国胃癌高发地区的易感人群中开展胃癌筛查项目是可行的，两轮筛查方法具有实用价值。应进一步加强胃癌早期检测的研究，组织多学科、多中心合作。有必要扩大胃癌筛查的实施范围，进一步完善早期检测方案，以便在目前的实践基础上取得突破。
