Effectiveness of the Korean National Cancer Screening Program in Reducing Gastric Cancer Mortality

It is not clear whether screening for gastric cancer by upper endoscopy or upper gastrointestinal (UGI) series examinations (looking at the upper and middle sections of the gastrointestinal tract by imaging techniques) reduces mortality. Nevertheless, the Korean National Cancer Screening Program for...

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Vydané v:Gastroenterology (New York, N.Y. 1943) Ročník 152; číslo 6; s. 1319
Hlavní autori: Jun, Jae Kwan, Choi, Kui Son, Lee, Hoo-Yeon, Suh, Mina, Park, Boyoung, Song, Seung Hoon, Jung, Kyu Won, Lee, Chan Wha, Choi, Il Ju, Park, Eun-Cheol, Lee, Dukhyoung
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 01.05.2017
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ISSN:1528-0012, 1528-0012
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Abstract It is not clear whether screening for gastric cancer by upper endoscopy or upper gastrointestinal (UGI) series examinations (looking at the upper and middle sections of the gastrointestinal tract by imaging techniques) reduces mortality. Nevertheless, the Korean National Cancer Screening Program for gastric cancer was launched in 1999 to screen individuals 40 years and older for gastric cancer using these techniques. We evaluated the effectiveness of these techniques in gastric cancer detection and compared their effects on mortality in the Korean population. We performed a nested case-control study using data from the Korean National Cancer Screening Program for gastric cancer since 2002. A total of 16,584,283 Korean men and women, aged 40 years and older, comprised the cancer-free cohort. Case subjects (n = 54,418) were defined as individuals newly diagnosed with gastric cancer from January 2004 through December 2009 and who died before December 2012. Cases were matched with controls (subjects who were alive on the date of death of the corresponding case subject, n = 217,672) for year of entry into the study cohort, age, sex, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained via conditional logistic regression analysis. Compared with subjects who had never been screened, the overall OR for dying from gastric cancer among ever-screened subjects was 0.79 (95% CI, 0.77-0.81). According to screening modality, the ORs of death from gastric cancer were 0.53 (95% CI, 0.51-0.56) for upper endoscopy and 0.98 (95% CI, 0.95-1.01) for UGI series. As the number of endoscopic screening tests performed per subject increased, the ORs of death from gastric cancer decreased: 0.60 (95% CI, 0.57-0.63), 0.32 (95% CI, 0.28-0.37), and 0.19 (95% CI, 0.14-0.26) for once, twice, and 3 or more times, respectively. Within the Korean National Cancer Screening Program, patients who received an upper endoscopy were less likely to die from gastric cancer; no associations were found for UGI series.
AbstractList It is not clear whether screening for gastric cancer by upper endoscopy or upper gastrointestinal (UGI) series examinations (looking at the upper and middle sections of the gastrointestinal tract by imaging techniques) reduces mortality. Nevertheless, the Korean National Cancer Screening Program for gastric cancer was launched in 1999 to screen individuals 40 years and older for gastric cancer using these techniques. We evaluated the effectiveness of these techniques in gastric cancer detection and compared their effects on mortality in the Korean population. We performed a nested case-control study using data from the Korean National Cancer Screening Program for gastric cancer since 2002. A total of 16,584,283 Korean men and women, aged 40 years and older, comprised the cancer-free cohort. Case subjects (n = 54,418) were defined as individuals newly diagnosed with gastric cancer from January 2004 through December 2009 and who died before December 2012. Cases were matched with controls (subjects who were alive on the date of death of the corresponding case subject, n = 217,672) for year of entry into the study cohort, age, sex, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained via conditional logistic regression analysis. Compared with subjects who had never been screened, the overall OR for dying from gastric cancer among ever-screened subjects was 0.79 (95% CI, 0.77-0.81). According to screening modality, the ORs of death from gastric cancer were 0.53 (95% CI, 0.51-0.56) for upper endoscopy and 0.98 (95% CI, 0.95-1.01) for UGI series. As the number of endoscopic screening tests performed per subject increased, the ORs of death from gastric cancer decreased: 0.60 (95% CI, 0.57-0.63), 0.32 (95% CI, 0.28-0.37), and 0.19 (95% CI, 0.14-0.26) for once, twice, and 3 or more times, respectively. Within the Korean National Cancer Screening Program, patients who received an upper endoscopy were less likely to die from gastric cancer; no associations were found for UGI series.
It is not clear whether screening for gastric cancer by upper endoscopy or upper gastrointestinal (UGI) series examinations (looking at the upper and middle sections of the gastrointestinal tract by imaging techniques) reduces mortality. Nevertheless, the Korean National Cancer Screening Program for gastric cancer was launched in 1999 to screen individuals 40 years and older for gastric cancer using these techniques. We evaluated the effectiveness of these techniques in gastric cancer detection and compared their effects on mortality in the Korean population.BACKGROUND & AIMSIt is not clear whether screening for gastric cancer by upper endoscopy or upper gastrointestinal (UGI) series examinations (looking at the upper and middle sections of the gastrointestinal tract by imaging techniques) reduces mortality. Nevertheless, the Korean National Cancer Screening Program for gastric cancer was launched in 1999 to screen individuals 40 years and older for gastric cancer using these techniques. We evaluated the effectiveness of these techniques in gastric cancer detection and compared their effects on mortality in the Korean population.We performed a nested case-control study using data from the Korean National Cancer Screening Program for gastric cancer since 2002. A total of 16,584,283 Korean men and women, aged 40 years and older, comprised the cancer-free cohort. Case subjects (n = 54,418) were defined as individuals newly diagnosed with gastric cancer from January 2004 through December 2009 and who died before December 2012. Cases were matched with controls (subjects who were alive on the date of death of the corresponding case subject, n = 217,672) for year of entry into the study cohort, age, sex, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained via conditional logistic regression analysis.METHODSWe performed a nested case-control study using data from the Korean National Cancer Screening Program for gastric cancer since 2002. A total of 16,584,283 Korean men and women, aged 40 years and older, comprised the cancer-free cohort. Case subjects (n = 54,418) were defined as individuals newly diagnosed with gastric cancer from January 2004 through December 2009 and who died before December 2012. Cases were matched with controls (subjects who were alive on the date of death of the corresponding case subject, n = 217,672) for year of entry into the study cohort, age, sex, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained via conditional logistic regression analysis.Compared with subjects who had never been screened, the overall OR for dying from gastric cancer among ever-screened subjects was 0.79 (95% CI, 0.77-0.81). According to screening modality, the ORs of death from gastric cancer were 0.53 (95% CI, 0.51-0.56) for upper endoscopy and 0.98 (95% CI, 0.95-1.01) for UGI series. As the number of endoscopic screening tests performed per subject increased, the ORs of death from gastric cancer decreased: 0.60 (95% CI, 0.57-0.63), 0.32 (95% CI, 0.28-0.37), and 0.19 (95% CI, 0.14-0.26) for once, twice, and 3 or more times, respectively.RESULTSCompared with subjects who had never been screened, the overall OR for dying from gastric cancer among ever-screened subjects was 0.79 (95% CI, 0.77-0.81). According to screening modality, the ORs of death from gastric cancer were 0.53 (95% CI, 0.51-0.56) for upper endoscopy and 0.98 (95% CI, 0.95-1.01) for UGI series. As the number of endoscopic screening tests performed per subject increased, the ORs of death from gastric cancer decreased: 0.60 (95% CI, 0.57-0.63), 0.32 (95% CI, 0.28-0.37), and 0.19 (95% CI, 0.14-0.26) for once, twice, and 3 or more times, respectively.Within the Korean National Cancer Screening Program, patients who received an upper endoscopy were less likely to die from gastric cancer; no associations were found for UGI series.CONCLUSIONSWithin the Korean National Cancer Screening Program, patients who received an upper endoscopy were less likely to die from gastric cancer; no associations were found for UGI series.
Author Jun, Jae Kwan
Park, Eun-Cheol
Choi, Kui Son
Suh, Mina
Lee, Dukhyoung
Lee, Hoo-Yeon
Park, Boyoung
Song, Seung Hoon
Lee, Chan Wha
Jung, Kyu Won
Choi, Il Ju
Author_xml – sequence: 1
  givenname: Jae Kwan
  surname: Jun
  fullname: Jun, Jae Kwan
  organization: National Cancer Control Institute, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea; Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
– sequence: 2
  givenname: Kui Son
  surname: Choi
  fullname: Choi, Kui Son
  email: kschoi@ncc.re.kr
  organization: National Cancer Control Institute, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea; Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, Republic of Korea. Electronic address: kschoi@ncc.re.kr
– sequence: 3
  givenname: Hoo-Yeon
  surname: Lee
  fullname: Lee, Hoo-Yeon
  organization: Department of Social Medicine, College of Medicine, Dankook University, Cheonan, Chungnam, Republic of Korea
– sequence: 4
  givenname: Mina
  surname: Suh
  fullname: Suh, Mina
  organization: National Cancer Control Institute, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
– sequence: 5
  givenname: Boyoung
  surname: Park
  fullname: Park, Boyoung
  organization: National Cancer Control Institute, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea; Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
– sequence: 6
  givenname: Seung Hoon
  surname: Song
  fullname: Song, Seung Hoon
  organization: National Cancer Control Institute, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
– sequence: 7
  givenname: Kyu Won
  surname: Jung
  fullname: Jung, Kyu Won
  organization: National Cancer Control Institute, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
– sequence: 8
  givenname: Chan Wha
  surname: Lee
  fullname: Lee, Chan Wha
  organization: Center for Cancer Prevention and Detection, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
– sequence: 9
  givenname: Il Ju
  surname: Choi
  fullname: Choi, Il Ju
  organization: Center for Gastric Cancer, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
– sequence: 10
  givenname: Eun-Cheol
  surname: Park
  fullname: Park, Eun-Cheol
  email: ecpark@yuhs.ac
  organization: Department of Preventive Medicine, Institute of Health Services Research, College of Medicine, Yonsei University, Seoul, Republic of Korea. Electronic address: ecpark@yuhs.ac
– sequence: 11
  givenname: Dukhyoung
  surname: Lee
  fullname: Lee, Dukhyoung
  organization: National Cancer Control Institute, National Cancer Center Hospital, National Cancer Center, Goyang, Gyeonggi, Republic of Korea; Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi, Republic of Korea
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28147224$$D View this record in MEDLINE/PubMed
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Keywords Photofluorography
Mass Screening
Endoscopy
Stomach Neoplasms
Language English
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PublicationTitle Gastroenterology (New York, N.Y. 1943)
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Snippet It is not clear whether screening for gastric cancer by upper endoscopy or upper gastrointestinal (UGI) series examinations (looking at the upper and middle...
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SubjectTerms Adult
Aged
Aged, 80 and over
Case-Control Studies
Early Detection of Cancer - methods
Early Detection of Cancer - statistics & numerical data
Endoscopy, Gastrointestinal - statistics & numerical data
Female
Humans
Male
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Odds Ratio
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Republic of Korea
Stomach Neoplasms - diagnostic imaging
Stomach Neoplasms - mortality
Title Effectiveness of the Korean National Cancer Screening Program in Reducing Gastric Cancer Mortality
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