Three-year interval for endoscopic screening may reduce the mortality in patients with gastric cancer
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Endoscopic screening has been adopted in South Korea for the national screening of gastric cancer (GC). This study aimed to assess the effect on overall survival of GC patients and determine the optimal endoscopic screening interval.
The baseline characteristics and overall survival of GC patients treated at the National Cancer Center, Korea, between 2010 and 2016 were compared between those without a history of endoscopic evaluation (group N) and those in whom the interval between the last endoscopic evaluations and diagnosis of GC was ≤ 1, 1–2, 2–3, 3–4, or > 4 years (groups 1–5, respectively).
A total of 2362 patients met the criteria for the study (1060 in group N and 1302 in groups 1–5). More patients in groups 1–5 were diagnosed with stage I GC (83.7, 83.7, 71.8, 78.2, and 71.6%, respectively) than in group N (62.4%, P < 0.001) and were treated endoscopically (38.8, 33.8, 24.7, 21.8, and 15.5%, respectively, vs. 13.5%; P < 0.001). Group 2 had less-advanced tumor stages (P = 0.001) and was more likely to have received endoscopic treatments (P = 0.026) than group 3. Hazard ratios for death were significantly lower in groups 2 (0.45; 95% confidence interval [CI], 0.32–0.64) and 3 (0.57; 95% CI, 0.33–0.98) than in group N; the decrease was not significant in group 4 (0.49, 95% CI, 0.20–1.20).
Endoscopic screening every 3 years may reduce the mortality of GC patients, though screenings at least every 2 years may benefit patients with less-advanced stages.
KeywordsEndoscopic screening program Overall survival Gastric cancer Screening
SIC contributed to data acquisition, analysis and interpretation of data, and drafting of the manuscript; BP contributed to statistical analysis, interpretation of data, and drafting of the manuscript; JJ contributed to statistical analysis, interpretation of data, administrative support; Y-IK contributed to material support and critical revision of the manuscript for important intellectual content; JYL contributed to material support and critical revision of the manuscript for important intellectual content; CGK contributed to material support and critical revision of the manuscript for important intellectual content; IJC contributed to material support and critical revision of the manuscript for important intellectual content; M-CK contributed to material support and critical revision of the manuscript for important intellectual content; S-JC contributed to study concept and design, critical revision of the manuscript for important intellectual content, obtained funding, and study supervision.
This study was supported by a Grant from the National Cancer Center, Korea (#1610160-2) and the National Research Foundation, Korea (#NRF-2016R1A2B1010377).
Compliance with ethical standards
Dr. Sang Il Choi, Ms. Boram Park, Drs. Jungnam Joo, Young-Il Kim, Jong Yeul Lee, Chan Gyoo Kim, Il Ju Choi, Myeong-Cherl Kook, and Soo-Jeong Cho have no conflict of interest or financial ties to disclose.
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