Reduction of gastric cancer mortality by endoscopic and radiographic screening in an isolated island: A retrospective cohort study

OBJECTIVE: To evaluate the efficacy of endoscopic and radiographic screening for gastric cancer.

DESIGN: A retrospective cohort study.

SETTING: Community in an isolated island.

PARTICIPANTS: The study involved 186 patients (131 men, 55 women) diagnosed with gastric cancer between 2000 and 2005.

INTERVENTIONS: Endoscopic and radiographic screening.

MAIN OUTCOME MEASUREMENTS: The odds ratio of death from gastric cancer in participants versus non-participants of screening, the cumulative survival rate of the gastric cancer patients.

RESULTS: The odds ratio of death from gastric cancer in the participants versus non-participants of screening was 0.091 (95% confidence interval (CI) 0.027-0.308; P < 0.0001). The cumulative survival rate of the gastric cancer patients in the screening group was higher than that in the non-screening group (P < 0.0001). In the endoscopic screening district, the odds ratio of death from gastric cancer among the participants versus non-participants of endoscopic screening was 0.117 (95% CI 0.013-1.056; P = 0.0525), while in the radiographic screening district, it was 0.086 (95% CI 0.020-0.376; P < 0.0001). The cumulative survival rates were higher in both the screening groups as compared with the non-screening group (endoscopy, P = 0.0302; radiography, P = 0.0012).

CONCLUSION: The results suggest that both radiographic and endoscopic screening may prevent gastric cancer deaths.