Inadequate Evidence of Benefit Associated with Screening

Barium-meal photofluorography, gastric endoscopy, and serum pepsinogen

Based on fair evidence, screening with barium-meal photofluorography, gastric endoscopy, or serum pepsinogen would not result in a decrease in mortality from gastric cancer in areas with relatively low incidence of the disease, such as the United States[1][2][3][4].

Magnitude of Effect: Fair evidence for no reduction in mortality.

Study Design: Evidence obtained from case-control and cohort studies, primarily from high-risk areas such as Eastern Asia.

Internal Validity: Fair.

Consistency: Poor in prospective studies[5].

External Validity: Poor. Studies on populations in high-risk areas may not be applicable to low-risk areas such as the United States.

Based on solid evidence, screening would result in uncommon but serious side effects associated with endoscopy, which may include perforation, cardiopulmonary events, aspiration pneumonia, and bleeding requiring hospitalization.

Magnitude of Effect: Solid evidence for rare but serious harms.

Study Design: Evidence obtained from screening programs and from case series.

Internal Validity: Fair.

Consistency: Inadequate evidence.

External Validity: Poor.

References

1. Hirayama T, Hisamichi S, Fujimoto I, et al.: Screening for gastric cancer. In: Miller AB, ed.: Screening for Cancer. New York, NY: Academic Press, 1985, pp 367-376.

2. Tytgat GN, Mathus-Vliegen EM, Offerhaus J: Value of endoscopy in the surveillance of high-risk groups for gastrointestinal cancer. In: Sherlock P, Morson BC, Barbara L, et al., eds.: Precancerous Lesions of the Gastrointestinal Tract. New York, NY: Raven Press, 1983, pp 305-318.

3. Riecken B, Pfeiffer R, Ma JL, et al.: No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk. Prev Med 34 (1): 22-8, 2002.[PUBMED Abstract]

4. Kitahara F, Kobayashi K, Sato T, et al.: Accuracy of screening for gastric cancer using serum pepsinogen concentrations. Gut 44 (5): 693-7, 1999.[PUBMED Abstract]

5. Leung WK, Wu MS, Kakugawa Y, et al.: Screening for gastric cancer in Asia: current evidence and practice. Lancet Oncol 9 (3): 279-87, 2008.[PUBMED Abstract]

Next Section >
本站由 中国医学科学院医学信息研究所创办并维护 未经许可禁止转载或建立镜像