Cancer Screening Center, National Cancer Center Hospital, Tokyo, Japan.
Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Asian Pac J Cancer Prev. 2024 Apr 1;25(4):1247-1255. doi: 10.31557/APJCP.2024.25.4.1247.
Opportunistic endoscopic screening for gastric cancer was initiated in 2004 at our institute. We investigated chronological trends in gastric cancer detection rates based on individual characteristics and atrophic gastritis prevalence.
Overall, 15,081 asymptomatic individuals aged ≥40 years without a medical history of gastric cancer underwent first-time esophagogastroduodenoscopy in our institute between February 2004 and December 2017. We retrospectively investigated individual characteristics and endoscopic diagnoses by period (early period: 2004-2007, middle period: 2008-2012, and late period: 2013-2017), clarified the long-term detection rate and the characteristics of endoscopic screening-detected gastric cancer, and evaluated the relationship between gastric cancer and atrophic gastritis.
Gastric cancer detection rates in the early, middle, and late periods were 1.01% (76/7,503, men/women: 4,360/3,143, average age: 59.4 years, prevalence of atrophic gastritis: 72%), 0.69% (40/5,820, men/women: 3,668/2,152, average age: 56.8 years, prevalence of atrophic gastritis: 48%), and 0.46% (8/1,758, men/women: 1,083/675, average age: 58.7 years, prevalence of atrophic gastritis: 37%), respectively. Multivariate analysis revealed that male sex (odds ratio 1.92, 95% confidence interval 1.28-2.95), age ≥75 years (2.73, 95% CI 1.32-5.05), and atrophic gastritis (C1-C3: 2.21, 1.36-3.73, O1-O3: 5.36, 3.17-9.30) were significantly associated with the incidence of gastric cancer.
The gastric cancer detection rate and atrophic gastritis prevalence have decreased over time. However, continuing endoscopic screening is important, especially for those at a high risk of developing gastric cancer complicated by severe atrophic gastritis.
我们研究所于 2004 年开始进行胃癌机会性内镜筛查。我们根据个体特征和萎缩性胃炎的流行情况，调查了胃癌检出率的时间趋势。
2004 年 2 月至 2017 年 12 月，共有 15081 名无胃癌病史的≥40 岁无症状个体在我院首次行食管胃十二指肠镜检查。我们按时期（早期：2004-2007 年，中期：2008-2012 年，晚期：2013-2017 年）回顾性调查个体特征和内镜诊断，阐明长期检出率和内镜筛查检出胃癌的特征，并评估胃癌与萎缩性胃炎的关系。
早期、中期和晚期胃癌检出率分别为 1.01%（76/7503，男/女：4360/3143，平均年龄：59.4 岁，萎缩性胃炎患病率：72%）、0.69%（40/5820，男/女：3668/2152，平均年龄：56.8 岁，萎缩性胃炎患病率：48%）和 0.46%（8/1758，男/女：1083/675，平均年龄：58.7 岁，萎缩性胃炎患病率：37%）。多因素分析显示，男性（比值比 1.92，95%置信区间 1.28-2.95）、年龄≥75 岁（2.73，95%置信区间 1.32-5.05）和萎缩性胃炎（C1-C3：2.21，1.36-3.73，O1-O3：5.36，3.17-9.30）与胃癌的发生显著相关。
胃癌检出率和萎缩性胃炎患病率随时间推移而下降。然而，继续进行内镜筛查很重要，特别是对那些患有严重萎缩性胃炎并发胃癌风险较高的患者。
