| [ Summary ] |
The first Japanese guidelines for gastric cancer screening were published in 2005, and revised for the first time in 2014. In the previous guidelines, radiographic screening using an upper gastrointestinal radiography with a barium meal was the only method recommended. In the revised guidelines, mortality reduction from gastric cancer due to radiographic screening has been reevaluated, based on the previous guidelines and additional results obtained from cohort studies. Although endoscopic screening was not recommend in the previous guidelines, its effectiveness was evaluated based on the results of case‒control studies conducted in Korea and Japan. Although there were harms including adverse effects, false‒positive and overdiagnosis in radiographic and endoscopic screening, the rates of adverse effects were higher in endoscopic screening than those of radiographic screening. Based on the balance of benefits and harms, radiographic screening and endoscopic screening were both recommended for population‒based screening and opportunistic screening in the revised guidelines. Since there no evidence for reduction of mortality from gastric cancer was found, screening using a combination of Helicobacter pylori antibody and serum pepsinogen was not recommended for population‒based screening. However, this method can be used for risk stratification of gastric cancer. Evaluation of the effectiveness of endoscopic screening should be continued for validation. |