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. 2024 Feb 24;15(2):271-281.
doi: 10.5306/wjco.v15.i2.271.

Population-based X-ray gastric cancer screening in Hiroshima prefecture, Japan

Nhu Thi Hanh Vu  1   2 , Yuji Urabe  3 , Duc Trong Quach  1 , Shiro Oka  4 , Toru Hiyama  5
Affiliations

Population-based X-ray gastric cancer screening in Hiroshima prefecture, Japan

Nhu Thi Hanh Vu et al. World J Clin Oncol. .

Abstract

Background: X-ray gastric cancer (GC) screening has been shown to decrease mortality. Population-based X-ray GC screening has been performed in Hiroshima Prefecture, Japan, since 1983 but time trends and the efficacy of the method over 39 years have not been assessed.

Aim: To evaluate time trends and efficacy of population-based X-ray GC screening and identify challenges and suggested solutions for the future.

Methods: This was a population-based retrospective study. The data were derived from aggregated data of the Hiroshima Regional Health Medical Promotion Organization, including the number and rate of participants and those requiring esophagogastroduodenoscopies (EGDs), the number and rate of participants diagnosed as having GC, and the positive predictive value of the abnormal findings detected by X-ray and confirmed by EGDs. The number and rate of esophageal cancers were also collected. Further, the cost of detecting one GC was evaluated.

Results: The number of participants has decreased during the last four decades, from 39925 in 1983 to 12923 in 2021. The rate of those requiring EGDs decreased significantly in recent years (P < 0.001). The number of participants diagnosed as having GC has also declined, from 76 to 10 cases. However, the rate of cases diagnosed as GC among the participants remained around 0.1%. The positive predictive value increased significantly in recent years except during 1983-1991. The number and rate of accidentally detected esophageal cancers have risen recently, from 0% in 2008 to 0.02% in 2021, one-fifth of the diagnosis rate of GC. One GC diagnosis costs approximately 4200000 Japanese Yen (30000 United States Dollars) for the X-ray screenings and EGDs.

Conclusion: X-ray GC screening in Hiroshima has been efficient, but one challenge is the cost. Esophageal cancers may also need to be considered because they have gradually increased in recent years.

Keywords: Gastric cancer; Population; Retrospective studies; Screening; X-ray.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Trend in number of participants in X-ray gastric cancer screenings.
Figure 2
Figure 2
Age distribution of participants in X-ray gastric cancer screenings.
Figure 3
Figure 3
Trend in the number and rate of participants diagnosed with gastric cancer.
Figure 4
Figure 4
Rate of early-stages of gastric cancers among all gastric cancers detected in X-ray gastric screenings.
Figure 5
Figure 5
Positive predictive value of X-ray gastric cancer screenings.
Figure 6
Figure 6
A case of gastric cancer detected in the X-ray gastric screenings. A and B: The X-ray image showed an irregular area and nodularity abnormal in the upper gastric body (arrows); C: Endoscopy with indigo carmine identified a cancer in the upper gastric body; D: The pathological result after gastrectomy was a poorly differentiated adenocarcinoma, with macroscopic findings consistent with the X-ray imaging.
Figure 7
Figure 7
A case of gastric cancer detected in the X-ray gastric screenings. A and B: The X-ray image showed an irregular area and nodularity abnormal in the upper gastric body (arrows); C: Endoscopy with indigo carmine identified a cancer in the upper gastric body; D: The pathological result after gastrectomy was a poorly differentiated adenocarcinoma, with macroscopic findings consistent with the X-ray imaging.
See this image and copyright information in PMC

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References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71:209–249. - PubMed
    1. Rawla P, Barsouk A. Epidemiology of gastric cancer: global trends, risk factors and prevention. Prz Gastroenterol. 2019;14:26–38. - PMC - PubMed
    1. Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M, Bonaventure A, Valkov M, Johnson CJ, Estève J, Ogunbiyi OJ, Azevedo E Silva G, Chen WQ, Eser S, Engholm G, Stiller CA, Monnereau A, Woods RR, Visser O, Lim GH, Aitken J, Weir HK, Coleman MP CONCORD Working Group. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018;391:1023–1075. - PMC - PubMed
    1. Katanoda K, Hori M, Saito E, Shibata A, Ito Y, Minami T, Ikeda S, Suzuki T, Matsuda T. Updated Trends in Cancer in Japan: Incidence in 1985-2015 and Mortality in 1958-2018-A Sign of Decrease in Cancer Incidence. J Epidemiol. 2021;31:426–450. - PMC - PubMed
    1. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, Taniyama K, Sasaki N, Schlemper RJ. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–789. - PubMed