臨牀消化器内科 Vol.23 No.3(4)


特集名 胃癌スクリーニングの現況とハイリスクストラテジー
題名 胃がん検診と死亡率減少効果 -- 有効性評価に基づく胃がん検診ガイドラインをめぐって
発刊年月 2008年 03月
著者 濱島 ちさと 国立がんセンターがん予防・検診研究センター検診技術開発部
【 要旨 】 有効性評価に基づく胃がん検診ガイドラインは，系統的総括に基づく定式化された作成手順により作成された．その結果，胃X線検査については，死亡率減少効果を示す相応な証拠があるので，対策型および任意型検診として，胃がん検診を実施することを勧めると判断された．一方，胃内視鏡検査，ペプシノゲン法およびHelicobacter pylori抗体については，胃がん検診として死亡率減少効果の有無を判断する証拠が不十分であるため，対策型検診としては勧められないと判断された．任意型検診として実施する場合，がん検診の提供者は，死亡率減少効果が証明されていないこと，および，当該検診による不利益について十分説明する責任を有する．
Theme Gastric Cancer Screening -- Present Status and Uprising High-risk Strategy
Title Gastric Cancer Screening in Relation to Mortality Reduction
Author Chisato Hamashima National Cancer Center, Research Center for Cancer Prevention and Screening, Cancer Screening Technology Division, Cancer Screening Research Section
[ Summary ] In previous guidelines, photofluorography has been recommended for gastric cancer screening. Guidelines for Cancer Screening, concerning the efficacies of various methods for gastric cancer screening were evaluated. These guidelines were developed based on the standardized method. Four methods for gastric cancer screening were evaluated ; photofluorography, endoscopy, the serum pepsinogen test and Helicobacter pylori antibody testing. Based on the balance of benefits (mortality reduction from gastric cancer) and harm done by screening, the recommendations for population-based and opportunistic screening were formulated. Gastric cancer screening, using photofluorography, was recommended for both screening programs. The other methods were not recommended for population-based screening due to insufficient evidence. Concerning opportunistic screening. If individuals request screening, they should be given appropriate information, and decisions should be made by individuals.
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