Mortality reduction from gastric cancer by endoscopic and radiographic screening
Menée au Japon auprès de 14 274 participants à un programme de dépistage des cancers gastriques (âge : 40 à 79 ans), cette étude compare l'efficacité d'un examen endoscopique et d'un examen radiographique pour réduire la mortalité spécifique
To evaluate mortality reduction from gastric cancer by endoscopic screening, we performed a population-based cohort study where both radiographic and endoscopic screenings for gastric cancer have been conducted. The subjects were selected from the participants of gastric cancer screening in 2 cities in Japan (i.e., Tottori and Yonago) from 2007 to 2008. The subjects were defined as participants aged 40-79 years who had no gastric cancer screening in the previous year. Follow-up of mortality was continued from the date of the first screening to the date of death or up to December 31, 2013. A Cox proportional hazards model was used to estimate the relative risk (RR) of gastric cancer incidence, gastric cancer death, all cancer deaths except gastric cancer death, and all-causes deaths except gastric cancer death. The numbers of subjects selected for endoscopic screening was 9,950 and that for radiographic screening was 4,324. The subjects screened by endoscopy showed a 67% reduction of gastric cancer compared with the subjects screened by radiography (adjusted RR by sex, age group, and resident city = 0.327, 95%CI: 0.118-0.908). The adjusted RR of endoscopic screening was 0.968 (95%CI: 0.675-1.387) for all cancer deaths except gastric cancer death and 0.929 (95%CI: 0.740-1.168) for all-causes deaths except gastric cancer death. This study indicates that endoscopic screening can reduce gastric cancer mortality by 67% compared with radiographic screening. This is consistent with previous studies showing that endoscopic screening reduces gastric cancer mortality. This article is protected by copyright. All rights reserved.
Cancer Science , résumé, 2014