Current Status of Diagnosis for Early Gastric Cancer Osamu Hosokawa 1 , Masaki Shimizu 2,3 , Yasuharu Kaizaki 4 , Tamon Miyanaga 1 , Yoshihide Asaumi 1 , Naoyuki Ibe 5 , Masakazu Hattori 1 , Kenji Dohden 1 , Yuichi Hayashida 1 , Chikashi Hiranuma 1 1Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan 2Health Promotion Division, Fukui Prefectural Government, Fukui, Japan 4Department of Pathology, Fukui Prefectural Hospital, Fukui, Japan 5Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan Keyword: 早期胃癌 , 地域がん登録 , 内視鏡診断精度 , 時代的変貌 , 相対生存率 pp.455-464
Published Date 2009/4/24
DOI https://doi.org/10.11477/mf.1403101618
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 The age-adjusted incidence rate of gastric cancer has decreased to two-thirds over the last 19 years, but little change was observed in the number of such malignancies registered in the Fukui Cancer Registry which is regarded as the most accurate in Japan. Because the ratio of early cancers reached 48% and the mucosal-cancer ratio, in particularly doubled, the relative five-year survival rate of gastric cancer rose by about 10% in the registry. The ratio of early cancers exceeds 70% in Fukui Prefectural Hospital in which a quarter of the patients in this prefecture have been treated. The mean age rose to 66.4 years. The ratio of patients with symptoms decreased by half and patients referred from opportunistic screening reached 56%. Recently, most of the cancers were detected by endoscopy, replacing x-ray examination, and 38% of lesions were endoscopically removed after 2000. The ratio of lesions occupying the upper stomach tripled and the macroscopic depressive-type increased while the mixed type decreased by half. The ratio of mucosal cancer increased, but the average diameter decreased, and lesions with the histological type of well differentiated tubular adenocarcinoma exceeded half. However, the false negative rate was 32% and the positive predictive value was 52% when endoscopic inspective diagnosis was compared with pathologic diagnosis of biopsy specimens. We concluded that endoscopic diagnosis for early gastric cancer is not yet satisfactory, no matter how much smaller and shallower the early gastric cancers may be.

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