「有効性評価に基づく胃がん検診ガイドライン」の基礎となった臨床研究

Studies on Endoscopic Screening for Gastric Cancer in the Japanese Guidelines for Gastric Cancer Screening 2014

要旨●2016年の厚生労働省指針改訂により，胃内視鏡検診が対策型検診として承認された．「有効性評価に基づく胃がん検診ガイドライン2004年版」では胃内視鏡検診の有効性を示す科学的根拠は不十分であり，対策型検診として推奨されなかった．がん検診の評価研究は段階を経て評価を行う必要があり，ガイドライン公開以降は，徐々に評価研究が蓄積された．さらに，日韓で行われた症例対照研究により，胃内視鏡検診の胃癌死亡率減少効果が認められ，「有効性評価に基づく胃がん検診ガイドライン2014年版」では胃内視鏡検診が対策型検診として推奨された．しかし，いずれも観察研究であることから，今後さらなる研究の積み重ねが必要である．

　Based on the recommendations provided by the revised guidelines, the Japanese government approved the use of endoscopic screening for gastric cancer as a population-based screening method in 2016. Previous guidelines contained limited evidence regarding the efficacy of endoscopic screening in reducing gastric cancer mortality ; therefore, endoscopic screening was not recommended. Evaluation studies accumulated after the previous guidelines were published. In addition, the results of case-control studies conducted in Korea and Japan were published. Based on the findings reported by these studies, the new guidelines recommended endoscopic screening as a population-based screening method. However, evidence supporting endoscopic screening for gastric cancer has been obtained from observational studies ; therefore, further studies are warranted.