No abstract available.
Early Detection of Cancer* ; Mortality* ; Stomach Neoplasms*

In addition to barium swallow, the health screening center of our hospital has started meansuring serum pepsinogen (PG) levels in the stomach cancer screening tests since 1998 if patients wish to receive the PG test. During the past five years, 94 gastric cancer cases were detected by both methods. The average detection ratio worked out at 79.8% for the barium method and 71.3% for the PG method. Of the 94 cases, 51.1% tested positive by both methods. The positivity ratio was 28.7% for the barium method alone and 20.2% for the pepsinogen method alone. In other words, it follows that nearly half of the cancer cases have been picked out by either of the two techniques. Therefore, it could be said that the two methods serve as complementary one to the other. Thus, it was confirmed that using the PG method together with the barium method is worthwhile.The hitting ratio of positive reaction was high in patients at level 2 and upward when checked according to PG levels, and in patients whose initial test results were negative and later shifted to level 2 or level 4 with the lapse of time. These findings suggest that it is feasible to presupposed a group of people at higher risk for developing gastric cancer.
Phosphatidylglycerols ; Pepsinogen A ; Stomach Cancer ; Serum ; Barium

Laparoscopy-assisted distal gastrectomy (LADG) has been advocated as a minimally invasive operation for early gastric cancer which needs regional lymph node resection. However, since it is technically too complicated and difficult to perform all laparoscopic procedures within the abdominal cavity, LADG has not become the standard surgical procedure for early gastric cancer. Moreover, a skin incision of approximately 5cm is required to allow the reconstruction of the digestive tract after gastrectomy. Therefore, we have developed an operative procedure which we call hand-assisted laparoscopic distal gastrectomy (HALDG). In this procedure we make a skin incision of 6cm, and the surgeon inserts his/her left hand into the abdomen to assist the laparoscopic procedure. The surgeon can move his/her left hand freely, to palpate and explore the organs, as in an open surgery. Therefore, the operation time can be shortened. Our results thus far obtained demonstrated that HALDG was as safe and effective as open distal gastrectomy. HALDG assures the patients a better quality of life, --less surgical trauma, less pain, speedy return to dialy life activities. Thus, it is beneficial to the patients with early gastric cancer. We, therefore, advocate the use of HALDG in such cases.
Gastrectomy ; Stomach Cancer ; Hand ; Procedures ; Pulmonary evaluation

Gastric cancer is the most common malignancy and the second leading cause of cancer-related death in Korea. The proportion of early gastric cancer among surgically treated patients with gastric cancer has been increasing (47.4% in 2004). Gastric cancer detected in early stage can be cured by endoscopic resection or less invasive surgical treatment and the subsequent prognosis is excellent. National cancer screening program for gastric cancer has been available for several years. Efforts to evaluate the efficacy of our screening strategy should be made in terms of mortality reduction and cost-effectiveness.
Early Detection of Cancer ; Humans ; Korea ; Mass Screening ; Prognosis ; Stomach Neoplasms

Since the introduction of endoscopic submucosal dissection method for the treatment of early gastric cancer, endoscopic treatment of early gastric cancer has increased exponentially. Accordingly, early diagnosis of cancerous or precancerous lesion has become one of the most important missions for endoscopists. The desire to improve diagnostic capability of white light endoscopy led to the development of new imaging techniques called "image enhanced endoscopy." The usefulness of these image enhanced endoscopy has not been proven yet, although there are several studies reporting diagnostic superiority of these new imaging methods over white light endoscopy. Among these new imaging modalities, narrow band image (NBI) with magnification endoscopy has been most widely used and studied. This manuscript will be focused on the NBI with magnification endoscopy.
Early Detection of Cancer ; Endoscopy ; Humans ; Light ; Missions and Missionaries ; Stomach Neoplasms

China has great burden of gastric cancer, and the diagnosis rate of early gastric cancer is relatively low (<10%). To perform screening, early endoscopic diagnosis and treatment of gastric cancer in high-risk population is a feasible and efficient way to change the current status. Therefore, the Chinese Society of Digestive Endoscopy recently issued Consensus on screening, "Endoscopic diagnosis and treatment of early gastric cancer screening in China". The consensus suggests a feasible and efficient strategy for early detection of gastric cancer: screening with non-invasive procedures, followed by intensive endoscopic examination for screened high-risk population. In this article, we also describe the current status, the causes, high-risk population and early diagnosis of gastric cancer in China; and review the new development of serology and endoscopic techniques for early diagnosis.
China ; Early Detection of Cancer ; methods ; Humans ; Stomach Neoplasms ; diagnosis

PURPOSE: This study aimed to analyze the effect of screening by using endoscopy on the diagnosis and treatment of gastric cancer. MATERIALS AND METHODS: The clinicopathologic characteristics of gastric cancer were compared in individuals who underwent an endoscopy because of symptoms (non-screening group) or for screening purposes (screening group). The distributions of gastric cancer stages and treatment modalities in 2006 and 2011 were compared. RESULTS: The proportion of patients in the screening group increased from 45.1% in 2006 to 65.4% in 2011 (P<0.001). The proportion of stage I cancers in the entire patient sample also increased (from 60.5% in 2006 to 70.6% in 2011; P=0.029). In 2011, the percentages of patients with cancer stages I, II, III, and IV were 79.9%, 8.2%, 10.9%, and 1.1%, respectively, in the screening group, and 47.9%, 10.8%, 29.8%, and 11.5%, respectively, in the non-screening group. The proportion of laparoscopic and robotic surgeries increased from 9.6% in 2006 to 48.3% in 2011 (P<0.001), and endoscopic submucosal dissection increased from 9.8% in 2006 to 19.1% 2011 (P<0.001). CONCLUSIONS: The proportion of patients diagnosed with gastric cancer by using the screening program increased between 2006 and 2011. This increase was associated with a high proportion of early-stage cancer diagnoses and increased use of minimally invasive treatments.
Diagnosis ; Early Detection of Cancer ; Endoscopy ; Humans ; Mass Screening* ; Stomach Neoplasms*

BACKGROUND: Stomach cancer is the most common cancer in korea. Stomach cancer has been the focus of screening for early detection. Few data are available regarding factors associated with participation in cancer screening examinations in general population. This study investigated associations of age, sex, residence, economic state, occupation, education years, marital status, health state, faith for stomach cancer screening with participation in screening tests for stomach cancer. METHODS: To identify the factors associated with participation in the stomach cancer screening examinations, 2133 persons above 40 years old were surveyed in 1998. RESULT: Stastically significant (P<0.05) strong predictors of regular stomach cancer screening were as follows: (1) urban residence, (2) high economic state, (3) possession on faith for regular screening of stomach cancer. CONCLUSION: Especially, rural residents should be educated about importance of stomach cancer screening.
Adult ; Early Detection of Cancer ; Education ; Humans ; Korea ; Marital Status ; Mass Screening* ; Occupations ; Stomach Neoplasms* ; Stomach*

OBJECTIVES: The purpose of this study was to examine the present status of cancer screening recommendations(beginning age, interval, recommended screening methods, etc.) by physicians and analyze the association between physician's characteristics and the content of their recommendations. METHODS: Data were collected from March 1 to April 30 of 1997, and 373 physicians who were from different hospital settings all over Korea were interviewed by telephone about their screening recommendations for stomach, cervical and breast cancer for those who provided cancer screening services. RESULTS: For stomach cancer screening, respondents recommended that cancer screening begin at 40 years of age(57.8%), with a 1 year interval(77.2%), and by gastrofibroscopy (86.2%). For cervical cancer screening, respondents recommended that cancer screening begin at 25 years of age(42.0%), with a 1 year interval(67.8%), and by using a Pap smear(100.0%). For breast cancer screening, respondents recommended that cancer screening begin at 35 years of age(38.7%), with a 1 year interval(57.3%), and by mammography (97.3%). CONCLUSIONS: To establish appropriate cancer screening recommendations for Korea, it may be useful to consider the above results concerning medical care providers.
Breast Neoplasms ; Surveys and Questionnaires ; Early Detection of Cancer* ; Korea ; Mammography ; Mass Screening ; Stomach ; Stomach Neoplasms ; Telephone ; Uterine Cervical Neoplasms

PURPOSE: To compare the image quality of UGIS (upper gastrointestinal series) obtained by direct radiography with that of UGIS obtained by indirect radiography in a mass screening program for gastric cancer, and to assess the validity of UGIS by indirect radiography. MATERIALS AND METHODS: A total of 994 persons participated in a mass screening test for gastric cancer between March 2003 and April 2003 at the Korea Association of Health Promotion (KAHP). Of these 994 persons, 494 underwent UGIS by direct radiography, while the remaining 500 underwent UGIS by indirect radiography (i.e. photofluorography using a mirror camera and a 100 mm-roll film). We compared the image quality of UGIS obtained by direct and indirect radiography with, in each case, the image quality being graded as 'excellent', 'good', 'fair', 'poor' or 'very poor'. RESULTS: The image quality of UGIS by both direct and indirect radiography was similar: most images in both groups were rated as either 'excellent', 'good', or 'fair', while the incidences of poorly rated images were similar in both cases (5% versus 6%, respectively); and there were no images rated as 'very poor' in either case. For certain sites of the stomach, the image quality of UGIS by direct radiography was superior to that of UGIS by indirect radiography, namely at the cardia (p<0.001) and duodenum (p=0.001). However, for other sites of the stomach, the image quality of UGIS by both direct and indirect radiography was similar, namely at the body (p=0.043) and pylorus (p>0.05). CONCLUSION: There was no significant difference in the image quality between UGIS by indirect and direct radiography. Therefore, UGIS by indirect radiography may be used as a method of mass screening for gastric cancer.
Barium ; Cardia ; Duodenum ; Early Detection of Cancer ; Health Promotion ; Humans ; Incidence ; Korea ; Mass Screening* ; Photofluorography ; Pylorus ; Radiography* ; Stomach ; Stomach Neoplasms*