Effects of screening on gastric cancer management: comparative analysis of the results in 2006 and in 2011

Abstract

Purpose: This study aimed to analyze the effect of screening by using endoscopy on the diagnosis and treatment of gastric cancer.

Materials and methods: The clinicopathologic characteristics of gastric cancer were compared in individuals who underwent an endoscopy because of symptoms (non-screening group) or for screening purposes (screening group). The distributions of gastric cancer stages and treatment modalities in 2006 and 2011 were compared.

Results: The proportion of patients in the screening group increased from 45.1% in 2006 to 65.4% in 2011 (P<0.001). The proportion of stage I cancers in the entire patient sample also increased (from 60.5% in 2006 to 70.6% in 2011; P=0.029). In 2011, the percentages of patients with cancer stages I, II, III, and IV were 79.9%, 8.2%, 10.9%, and 1.1%, respectively, in the screening group, and 47.9%, 10.8%, 29.8%, and 11.5%, respectively, in the non-screening group. The proportion of laparoscopic and robotic surgeries increased from 9.6% in 2006 to 48.3% in 2011 (P<0.001), and endoscopic submucosal dissection increased from 9.8% in 2006 to 19.1% 2011 (P<0.001).

Conclusions: The proportion of patients diagnosed with gastric cancer by using the screening program increased between 2006 and 2011. This increase was associated with a high proportion of early-stage cancer diagnoses and increased use of minimally invasive treatments.

Keywords: Early detection of cancer; Stomach neoplasms; Therapeutics.

Fig. 1

Proportion of patients with gastric cancer detected through screening by using endoscopy. ^*Refered from the article of Kong et al..

Fig. 2

Proportion of gastric cancers at each stage in 2006 and 2011.

Fig. 3

Stage of gastric cancer in different age groups in 2006 and 2011.

Fig. 4

Stage of gastric cancer and patient-reported symptoms.

Fig. 5

Surgical management of gastric cancer according to stage in 2006 and 2011.