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Published on: August 9, 2016
Participation and Yield of Gastric Cancer Screening Programs: A Systematic Review and Meta-analysis
Jiayue Wang1, Xianzhu Zhou1, Huiyun Zhu1
1Department of Gastroenterology, The National Clinical Research Center for Digestive Diseases, Changhai Hospital, National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai, China.
Background & Aims:
Hundreds of gastric cancer (GC) screening programs have been launched worldwide over the past 3 decades. However, no comprehensive study evaluating the outcomes of these programs has been conducted.
Methods:
This meta-analysis aimed to evaluate the temporal and geographical patterns of three key indicators in GC screening programs: endoscopic uptake rate (EUR), GC detection rate (GCDR), and early GC detection rate (EGCDR). The search was conducted until September 20, 2023. Pooled random-effect estimates of the indicators were computed, with further subgroup analysis stratified by study period, country, screening setting, local GC age-standardized incidence, and pre-screening modality.
Results:
A total of 67 studies were included in the analysis. Of these, 42 reported an EUR of 46% (95% confidence interval [CI], 41%-52%), 47 reported a GCDR of 0.76% (95% CI, 0.55%-0.96%), and 27 reported an EGCDR of 59% (95% CI, 49%-70%). Developed countries demonstrated notably superior performance in EUR (51% vs 37%; P = .009) and EGCDR (78% vs 44%; P < .001) compared with developing countries. A gradual increase in the EUR was found, rising from 46% pre-2010 to 48% post-2010 (P = .739). In contrast, both GCDR and EGCDR exhibited a slight decline, with GCDR decreasing from 0.78% pre-2010 to 0.75% post-2010 (P = .905), and EGCDR from 65% pre-2010 to 56% post-2010 (P = .404). Multivariate meta-regression analysis revealed that a higher local GC incidence and studies conducted in Japan were independently associated with higher values of both EUR (P = .010 and P = .027, respectively) and EGCDR (P = .008 and P = .002).
Conclusions:
The participation and yield of GC screening programs were comprehensively assessed using 3 indicators proposed in this study.
