Abe Y, Mitsushima T, Nagatani K, Ikuma H, Minamihara Y
Tokyo Marine Clinic.
Nihon Shokakibyo Gakkai Zasshi. 1995 May;92(5):836-45.
An epidemiological evaluation of the protective effect for dying of stomach cancer by screening programme for stomach cancer was conducted with applying a method of case-control study. And also in order to carry out an efficient screening programme, the age groups who should be intensively recommended to receive screening and an optimal screening time interval since the last test were analyzed. 527 cases of men and 273 of women, dying of stomach cancer in the years 1981-1989 in the Awa region of Chiba prefecture, were identified from Chiba Cancer Registry. For each case, 3 controls were drawn at random from Awa living residents (about 162000 inhabitants at 1989 national census), with being matched strictly according to the district of residence, sex and born within 3 years of birth-year. For both cases and controls, the information about the screening history until the date of diagnosis of the case in each matched set was collected respectively from comparison with the screening certification. The results showed a relative risk of 0.417 (99% CI 0.284-0.612) in ever screened men compared with never screened and 0.480 (99% CI 0.280-0.823) in women. The significant reduction in risk was intensively observed on age groups 40-74 years among men and 50-69 years among women and the protective effect continued at most in the following three years since last screening. For an efficiency of screening programme, these age groups should be intensively recommended to receive screening and it is allowable that an optimal screening time interval since last negative test is at most 3 years for general attendance.
采用病例对照研究方法,对胃癌筛查计划预防胃癌死亡的保护效果进行了流行病学评估。此外,为了实施有效的筛查计划,还分析了应强烈推荐接受筛查的年龄组以及自上次检查以来的最佳筛查时间间隔。从千叶癌症登记处确定了1981年至1989年在千叶县阿波地区死于胃癌的527例男性和273例女性。对于每例病例,从阿波地区的常住居民(根据1989年全国人口普查约有162000居民)中随机抽取3名对照,严格按照居住地区、性别和出生年份在3年内进行匹配。对于病例和对照,分别通过与筛查证明进行比较,收集了每个匹配组中直至病例诊断日期的筛查历史信息。结果显示,与未筛查的男性相比,曾接受筛查的男性相对风险为0.417(99%可信区间0.284 - 0.612),女性为0.480(99%可信区间0.280 - 0.823)。在40 - 74岁的男性和50 - 69岁的女性年龄组中,风险显著降低,并且自上次筛查后,保护作用最多持续三年。为提高筛查计划的效率,应强烈推荐这些年龄组接受筛查,对于一般人群,自上次阴性检查后的最佳筛查时间间隔最多为3年是可行的。