早期胃癌検診の現状

Current Status of Early Gastric Cancer Screening

要旨●胃がん検診として年間600万件以上の胃X線検診が実施されている．2014年に対策型胃がん検診として認可された内視鏡検診は増加しているが，実施可能件数に限界がある．さらに，H. pylori感染者が低下している現状では，内視鏡検診に胃癌リスク層別化検査の導入は不可欠である．一方，除菌治療後の検診受診者が急増している今日，内視鏡でも発見困難な形態の除菌後胃癌への対応も問題である．従来の胃がん検診は限界に来ており，複数の学会が協調して，胃癌発症リスクを加えX線と内視鏡が連携した新しい視点から胃がん検診体制の構築が必要である．

　More than 6 million gastric X-ray examinations are annually conducted for screening gastric cancer. Although the number of endoscopic screening systems approved for population-based screening in 2014 will increase, there is a limit to the number of systems that can be implemented. In the current scenario where the number of people infected with Helicobacter pylori is decreasing, it is indispensable to introduce gastric cancer risk stratification for endoscopic screening. Meanwhile, it is a problem to deal with gastric cancer after H. pylori eradication, which is difficult to detect even by endoscopy, as the number of screening examinations after H. pylori eradication rapidly increases. As conventional gastric cancer screening has reached its limit, it is necessary to construct a gastric cancer screening system from a new perspective in which X-ray examinations and endoscopy are performed together ; this system is being prepared by several academic societies collaborating with each other and will increase the screening rate of gastric cancer.