J Korean Med Assoc.  2015 May;58(5):373-384. 10.5124/jkma.2015.58.5.373.

The Korean guideline for gastric cancer screening

Affiliations
  • 1Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 2Department of Gastroenterology, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea.
  • 3Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
  • 6Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
  • 8Department of Pathology, Konkuk University School of Medicine, Seoul, Korea.
  • 9Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 10Department of Pathology and Translational Genomics, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 11Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 12Department of Preventive Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
  • 13Center for Gastric Cancer, National Cancer Center, Goyang, Korea.
  • 14Department of Radiology, Soonchunhyang University Hospital, Seoul, Korea.
  • 15National Cancer Control Institute, National Cancer Center, Goyang, Korea.
  • 16Department of Oriental Gynecology, CHA Bundang Medical Center, Seongnam, Korea.
  • 17Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  • 18Department of Preventive Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
  • 19Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. euschung@schmc.ac.kr

Abstract

Despite improvements in treatment modalities, gastric cancer is the second cause of mortality among Korean men and third among females in Korea. Korea implemented a gastric cancer screening program for the general population in 1999. However, the effectiveness and harms of gastric cancer screening using gastric endoscopy and upper gastrointestinal (UGI) series have not been fully evaluated. In an effort to evaluate the screening program, the Korean multidisciplinary expert committee for developing a gastric cancer screening guideline systematically reviewed the evidence regarding the benefits and harms of gastric cancer screening, and developed an evidence-based clinical guideline. There is 'low' level evidence that gastric cancer screening using gastric endoscopy or UGI series can reduce gastric cancer mortality for asymptomatic adults aged between 40 to 74 years. The benefits of gastric cancer screening using gastric endoscopy are substantially higher than its harms, while the benefits of screening with UGI series are moderately higher. We recommend that asymptomatic adults from 40 to 75 years of age undergo biannual gastric cancer screening using gastric endoscopy (recommendation B). Gastric cancer screening using UGI series in asymptomatic adults aged between 40 to 74 years may be recommended based on clinicians' judgment regarding the patient's risk and the patient's preference (recommendation C). There is insufficient evidence to assess the benefits and harms of gastric cancer screening for adults aged between 75 to 84 years (recommendation I). We recommend against gastric cancer screening for adults older than 85 years (recommendation D).

Keyword

Early detection of cancer; Gastric neoplasms; Guideline; Gastric endoscopy; Upper gastrointestinal series

MeSH Terms

Adult
Early Detection of Cancer
Endoscopy
Female
Humans
Judgment
Korea
Male
Mass Screening*
Mortality
Stomach Neoplasms*
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