Gastric cancer screening in selected population of Moscow region: retrospective evaluation |
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Authors: | L M Portnoi I A Kazantseva V A Isakov V I Nefedova L E Gaganov |
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Institution: | (1) Department of Radiology, Moscow Regional Research Clinical Institute (MONIKI), Schepkin st., 61/2, Moscow, 129110, Russia, RU;(2) Department of Pathology, Moscow Regional Research Clinical Institute (MONIKI), Schepkin st., 61/2, Moscow, 129110, Russia, RU;(3) Department of Gastroenterology, Moscow Regional Research Clinical Institute (MONIKI), Schepkin st., 61/2, Moscow, 129110, Russia, RU |
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Abstract: | The aim of the study was to evaluate the efficacy of photofluorographic gastric cancer screening in selected population of
Moscow Region (Russia) during a 15-year period. Thirty-five thousand patients were examined annually with photofluorography
(tight filling and double contrast) of the stomach. Gastroscopy with multiple biopsies was performed in suspicious or inconclusive
cases. Dynamic CT scan with air distention of the stomach was made before the operation for precise determination of tumor
size as well as in some inconclusive cases. The final diagnosis was made by histologic examination of resected stomach. A
total of 4286 patients dropped out of the study. In 25,392 patients no pathology was found. Gastric cancer was diagnosed in
680 (1.94 %) of patients. In the study 170 (25 %) “early” gastric cancers and 510 (75 %) advanced gastric cancers were found.
Among 170 early gastric cancers 120 (70 %) were type-IIb (flat carcinoma) lesions in which endoscopy had low positive predictive
value due to nonspecific picture and negative biopsy. On the contrary, dynamic CT scan with air distention of the stomach
revealed local thickening of stomach wall in 118 of 120 (98.3 %) of the tumors and correctly determined their sizes in 106
of 120 (89.9 %). Gastric cancer screening by means of photofluorography in selected groups of patients is efficient and cost-effective.
In doubtful cases with negative biopsies and nonspecific endoscopic image, dynamic CT scan with air distention of the stomach
can be a method of choice.
Received: 9 June 1998; Accepted: 30 June 1998 |
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Keywords: | : Gastric cancer screening Barium examination Double-contrast examination CT scan |
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