Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Trends in the Performance of the Korean National Cancer Screening Program for Gastric Cancer from 2007 to 2016: Ji Eun Ryu, Eunji Choi, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kyu Won Jung, Kui Son Choi; Cancer Res Treat. 2022;54(3):842-849. Published online September 30, 2021; DOI: https://doi.org/10.4143/crt.2021.482

Abstract PDF Supplementary Material PubReader ePub

Purpose
The Korean National Cancer Screening Program (KNCSP) has implemented two screening methods for gastric cancer—upper gastrointestinal series (UGIS) and endoscopy—for Koreans aged ≥40 years. We aimed to assess performance trends for both screening methods.
Materials and Methods
The KNCSP database was used to evaluate individuals who underwent screening from 2007 to 2016. The final gastric cancer diagnosis was ascertained by linking with the Korean Central Cancer Registry. We conducted a prospective, cross-sectional analysis to estimate performance indicators of gastric cancer screening by UGIS and endoscopy, stratified by sociodemographic factors.
Results
We found that screening rates for gastric cancer increased from 28% to 51.7% between 2007 and 2016, and that the rate of endoscopy use for gastric cancer screening increased sharply. Cancer detection rates (CDR) of UGIS and endoscopy were 0.41 and 2.25 per 1,000 screens in 2007–2008 and 0.26 and 1.99 in 2015–2016, respectively. Interval cancer rates (ICR) per 1,000 negative screenings were 1.33 (2007–2008) and 1.21 (2015–2016) for UGIS and 1.14 (2007–2008) and 0.88 (2015–2016) for endoscopy. The sensitivity of UGIS decreased from 23.6% (2007–2008) to 17.6% (2015–2016), whereas that of endoscopy increased from 66.4% (2007–2008) to 69.3% (2015–2016). Specificity was maintained at >99% for both methods over the study period.
Conclusion
The use of endoscopy for gastric cancer screening within the KNCSP has increased. Endoscopy has higher CDR, sensitivity, and specificity, and lower ICR estimates than does UGIS.

Citations

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Journal of Korean Medical Science.2025;[Epub] CrossRef
Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline)
In-Ho Kim, Seung Joo Kang, Wonyoung Choi, An Na Seo, Bang Wool Eom, Beodeul Kang, Bum Jun Kim, Byung-Hoon Min, Chung Hyun Tae, Chang In Choi, Choong-kun Lee, Ho Jung An, Hwa Kyung Byun, Hyeon-Su Im, Hyung-Don Kim, Jang Ho Cho, Kyoungjune Pak, Jae-Joon Kim
Journal of Gastric Cancer.2025; 25(1): 5. CrossRef
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Effectiveness of Gastric Cancer Screening on Gastric Cancer Incidence and Mortality in a Community-Based Prospective Cohort: Heewon Kim, Yunji Hwang, Hokyung Sung, Jieun Jang, Choonghyun Ahn, Sang Gyun Kim, Keun-Young Yoo, Sue K. Park; Cancer Res Treat. 2018;50(2):582-589. Published online June 9, 2017; DOI: https://doi.org/10.4143/crt.2017.048

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was performed to investigate the effectiveness of gastric cancer (GC) screening methods in a community-based prospective cohort of the Korean Multi-center Cancer Cohort (KMCC) with over a 10-year follow-up.
Materials and Methods
A total 10,909 and 4,773 subjects from the KMCC with information on gastroendoscopy (GE) and upper gastrointestinal series (UGIS) were included in this study. Cox proportional hazard model adjusted for age, sex, Helicobacter pylori infection, cigarette smoking, and alcohol drinking was used to estimate the hazard ratios (HRs) and 95% confidence interval (CI).
Results
The GE screened subjects had almost half the risk of GC-specific death than that of unscreened subjects (HR, 0.58; 95% CI, 0.36 to 0.94). Among the GC patients, GE screenees had a 2.24-fold higher survival rate than that of the non-screenees (95% CI, 1.61 to 3.11). In particular, GE screenees who underwent two or more screening episodes had a higher survival rate than that of the non-screenees (HR, 13.11; 95% CI, 7.38 to 23.30). The effectiveness of GE screening on reduced GC mortality and increased survival rate of GC patients was better in elderly subjects (≥ 65 years old) (HR, 0.47; 95% CI, 0.24 to 0.95 and HR, 8.84; 95% CI, 3.63 to 21.57, respectively) than that in younger subjects (< 65 years old) (HR, 0.66; 95% CI, 0.34 to 1.29 and HR, 1.83; 95% CI, 1.24 to 2.68, respectively). In contrast, UGIS screening had no significant relation to GC mortality and survival.
Conclusion
The findings of this study suggest that a decreased GC-specific mortality and improved survival rate in GC patients can be achieved through GE screening.

Citations

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Optimal Interval for Repeated Gastric Cancer Screening in Normal-Risk Healthy Korean Adults: A Retrospective Cohort Study: Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim; Cancer Res Treat. 2015;47(4):564-568. Published online January 30, 2015; DOI: https://doi.org/10.4143/crt.2014.098

Abstract PDF PubReader ePub

Purpose
This retrospective cohort study was conducted to estimate the optimal interval for gastric cancer screening in Korean adults with initial negative screening results.
Materials and Methods
This study consisted of voluntary Korean screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative in the baseline screening performed between January 2007 and December 2011. A new case was defined as the presence of gastric cancer cells in biopsy specimens obtained upon gastroscopy. The follow-up periods were calculated during the months between the date of baseline screening gastroscopy and positive findings upon subsequent screenings, stratified by sex and age group. The mean sojourn time (MST) for determining the screening interval was estimated using the prevalence/incidence ratio.
Results
Of the 293,520 voluntary screenees for the gastric cancer screening program, 91,850 (31.29%) underwent subsequent screening gastroscopies between January 2007 and December 2011. The MSTs in men and women were 21.67 months (95% confidence intervals [CI], 17.64 to 26.88 months) and 15.14 months (95% CI, 9.44 to 25.85 months), respectively.
Conclusion
These findings suggest that the optimal interval for subsequent gastric screening in both men and women is 24 months, supporting the 2-year interval recommended by the nationwide gastric cancer screening program.

Citations

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