Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Feb 24, 2024; 15(2): 271-281
Published online Feb 24, 2024. doi: 10.5306/wjco.v15.i2.271
Population-based X-ray gastric cancer screening in Hiroshima prefecture, Japan
Nhu Thi Hanh Vu, Yuji Urabe, Duc Trong Quach, Shiro Oka, Toru Hiyama
Nhu Thi Hanh Vu, Duc Trong Quach, Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 700000, Viet Nam
Nhu Thi Hanh Vu, Department of Endoscopy, Hiroshima University Hospital, Hiroshima 734-8551, Japan
Yuji Urabe, Department of Gastrointestinal Endoscopy and Medicine, Hiroshima University Hospital, Hiroshima 734-8551, Japan
Shiro Oka, Department of Gastroenterology, Hiroshima University Hospital, Hiroshima 734-8551, Japan
Toru Hiyama, Health Service Center, Hiroshima University, Higashihiroshima 739-8514, Japan
Author contributions: Hiyama T, Vu NTH contributed to the study’s conception; Vu NTH, Hiyama T, and Urabe Y conducted data curation; Hiyama T, Vu NTH, Oka S, Quach DT, and Urabe Y performed data analysis; Oka S, Hiyama T, and Quach DT supervised the study; Vu NTH drafted the initial manuscript; Hiyama T, Quach DT, Urabe Y, and Oka S reviewed and edited the manuscript.
Institutional review board statement: Ethical approval for this study was obtained from the Ethical Committee of Hiroshima University, Japan (approval No. E2023-0018).
Informed consent statement: Patients were not required to give informed consent because the study was a population-based retrospective study. The data were derived from the aggregated data of the Hiroshima Regional Health Medical Promotion Organization, and the analysis used anonymous data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toru Hiyama, MD, PhD, Professor, Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima 739-8514, Japan. tohiyama@hiroshima-u.ac.jp
Received: October 23, 2023
Peer-review started: October 23, 2023
First decision: November 29, 2023
Revised: December 11, 2023
Accepted: January 10, 2024
Article in press: January 10, 2024
Published online: February 24, 2024
Abstract
BACKGROUND

X-ray gastric cancer (GC) screening has been shown to decrease mortality. Population-based X-ray GC screening has been performed in Hiroshima Prefecture, Japan, since 1983 but time trends and the efficacy of the method over 39 years have not been assessed.

AIM

To evaluate time trends and efficacy of population-based X-ray GC screening and identify challenges and suggested solutions for the future.

METHODS

This was a population-based retrospective study. The data were derived from aggregated data of the Hiroshima Regional Health Medical Promotion Organization, including the number and rate of participants and those requiring esophagogastroduodenoscopies (EGDs), the number and rate of participants diagnosed as having GC, and the positive predictive value of the abnormal findings detected by X-ray and confirmed by EGDs. The number and rate of esophageal cancers were also collected. Further, the cost of detecting one GC was evaluated.

RESULTS

The number of participants has decreased during the last four decades, from 39925 in 1983 to 12923 in 2021. The rate of those requiring EGDs decreased significantly in recent years (P < 0.001). The number of participants diagnosed as having GC has also declined, from 76 to 10 cases. However, the rate of cases diagnosed as GC among the participants remained around 0.1%. The positive predictive value increased significantly in recent years except during 1983-1991. The number and rate of accidentally detected esophageal cancers have risen recently, from 0% in 2008 to 0.02% in 2021, one-fifth of the diagnosis rate of GC. One GC diagnosis costs approximately 4200000 Japanese Yen (30000 United States Dollars) for the X-ray screenings and EGDs.

CONCLUSION

X-ray GC screening in Hiroshima has been efficient, but one challenge is the cost. Esophageal cancers may also need to be considered because they have gradually increased in recent years.

Keywords: Population, Retrospective studies, X-ray, Gastric cancer, Screening

Core Tip: This was a population-based retrospective study to evaluate the time trends and efficacy of population-based X-ray gastric cancer screening in Hiroshima over the last four decades. The number of participants and those requiring esophagogastroduodenoscopies has decreased significantly. The number of participants diagnosed as having gastric cancer has also declined. However, the rate of cases diagnosed as gastric cancer among the participants remained around 0.1%. The positive predictive value also increased significantly. The number and rate of accidentally detected esophageal cancers have risen recently. One gastric cancer diagnosis costs approximately 4200000 Japanese Yen (30000 United States Dollars) for the X-ray screenings and esophagogastroduodenoscopies.