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Reevaluation of Gastric Cancer Screening by Levin's Equation.

Naoki Ishii1, Yasutoshi Shiratori2, Takahiko Yano1

  • 1Division of Gastroenterology, Tokyo Shinagawa Hospital, Tokyo, Japan.

Clinical and Translational Gastroenterology
|September 10, 2022
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Summary

Gastric cancer screening using fluoroscopy and endoscopy shows decreasing effectiveness, particularly in women. Population-attributable risk calculations reveal a declining impact of these screening methods on gastric cancer mortality over time.

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Area of Science:

  • Oncology
  • Public Health
  • Epidemiology

Background:

  • Gastric cancer remains a significant global health concern.
  • Population-level screening strategies are crucial for reducing cancer mortality.
  • The long-term effectiveness of established screening methods requires ongoing evaluation.

Purpose of the Study:

  • To reevaluate the population-level effectiveness of fluoroscopy and endoscopy in reducing gastric cancer mortality.
  • To analyze trends in gastric cancer mortality rates in relation to screening introduction.
  • To quantify the population-attributable risk (PAR) of gastric cancer mortality associated with the absence of screening.

Main Methods:

  • Utilized Cancer Registry and Statistics data to extract gastric cancer mortality and screening introduction rates.
  • Applied Levin's equation to calculate the population-attributable risk (PAR) percent of no screening for gastric cancer mortality.
  • Employed Jonckheere-Terpstra test and linear regression to assess trends in PAR across different decades and demographics.

Main Results:

  • A significant decrease in the PAR of gastric cancer mortality was observed in the total, male, and female populations.
  • The PAR of crude mortality rates in females significantly decreased in 2000-2009 and 2010-2019 compared to 1980-1989.
  • The PAR of age-adjusted mortality rates showed significant decreases in both males and females in recent decades.

Conclusions:

  • Levin's equation effectively estimates the PAR of no screening for gastric cancer mortality.
  • The effectiveness of current gastric cancer screening methods (fluoroscopy and endoscopy) appears to be diminishing.
  • A notable decrease in screening effectiveness was particularly observed in the female population.