X-ray screening of gastric cancer is broadly used in Japan, although no controlled trial has proved its effectiveness.
Drs Rosero-Bixby and Sierra from Costa Rica evaluated the impact of an X-ray screening demonstrative intervention to reduce gastric cancer mortality.
The evaluation follows a quasi-experimental, community-controlled design, with measures before and after.
|X-ray screening intervention had 88% sensitivity|
|British Journal of Cancer|
The team assessed about 7000 individuals who participated by invitation in the 2-wave screening programme.
X-ray screening was followed by videoendoscopy and gastric biopsies.
Treatment included resection with or without lymph node dissection.
The team found that gastric cancer mortality was halved in the period from 2 to 7 years after the first screening visit.
The team observed that x-rays as used in this intervention had 88% sensitivity, 80% specificity, and 3% predictive value for individuals with 2 screening visits.
The researchers noted that incidence in the screened group increased up to 4 times.
Case survival was 85% in the intervention group after 5 years.
The research team found that case survival was 12% among the controls before the intervention, and 35% among the controls in the same region after the intervention.
Dr Rosero-Bixby's and colleague comment, "Although x-ray mass screening seems able to reduce stomach cancer mortality, its high cost may be an obstacle for scaling up this intervention in a non-rich country like Costa Rica."