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Abstract：
BACKGROUND: Opportunistic endoscopic screening for gastric cancer was initiated in 2004 at our institute. We investigated chronological trends in gastric cancer detection rates based on individual characteristics and atrophic gastritis prevalence.
METHODS: Overall, 15,081 asymptomatic individuals aged ≥40 years without a medical history of gastric cancer underwent first-time esophagogastroduodenoscopy in our institute between February 2004 and December 2017. We retrospectively investigated individual characteristics and endoscopic diagnoses by period (early period: 2004-2007, middle period: 2008-2012, and late period: 2013-2017), clarified the long-term detection rate and the characteristics of endoscopic screening-detected gastric cancer, and evaluated the relationship between gastric cancer and atrophic gastritis.
RESULTS: Gastric cancer detection rates in the early, middle, and late periods were 1.01% (76/7,503, men/women: 4,360/3,143, average age: 59.4 years, prevalence of atrophic gastritis: 72%), 0.69% (40/5,820, men/women: 3,668/2,152, average age: 56.8 years, prevalence of atrophic gastritis: 48%), and 0.46% (8/1,758, men/women: 1,083/675, average age: 58.7 years, prevalence of atrophic gastritis: 37%), respectively. Multivariate analysis revealed that male sex (odds ratio 1.92, 95% confidence interval 1.28-2.95), age ≥75 years (2.73, 95% CI 1.32-5.05), and atrophic gastritis (C1-C3: 2.21, 1.36-3.73, O1-O3: 5.36, 3.17-9.30) were significantly associated with the incidence of gastric cancer.
CONCLUSIONS: The gastric cancer detection rate and atrophic gastritis prevalence have decreased over time. However, continuing endoscopic screening is important, especially for those at a high risk of developing gastric cancer complicated by severe atrophic gastritis.
METHODS: Overall, 15,081 asymptomatic individuals aged ≥40 years without a medical history of gastric cancer underwent first-time esophagogastroduodenoscopy in our institute between February 2004 and December 2017. We retrospectively investigated individual characteristics and endoscopic diagnoses by period (early period: 2004-2007, middle period: 2008-2012, and late period: 2013-2017), clarified the long-term detection rate and the characteristics of endoscopic screening-detected gastric cancer, and evaluated the relationship between gastric cancer and atrophic gastritis.
RESULTS: Gastric cancer detection rates in the early, middle, and late periods were 1.01% (76/7,503, men/women: 4,360/3,143, average age: 59.4 years, prevalence of atrophic gastritis: 72%), 0.69% (40/5,820, men/women: 3,668/2,152, average age: 56.8 years, prevalence of atrophic gastritis: 48%), and 0.46% (8/1,758, men/women: 1,083/675, average age: 58.7 years, prevalence of atrophic gastritis: 37%), respectively. Multivariate analysis revealed that male sex (odds ratio 1.92, 95% confidence interval 1.28-2.95), age ≥75 years (2.73, 95% CI 1.32-5.05), and atrophic gastritis (C1-C3: 2.21, 1.36-3.73, O1-O3: 5.36, 3.17-9.30) were significantly associated with the incidence of gastric cancer.
CONCLUSIONS: The gastric cancer detection rate and atrophic gastritis prevalence have decreased over time. However, continuing endoscopic screening is important, especially for those at a high risk of developing gastric cancer complicated by severe atrophic gastritis.
摘要：
背景：胃癌的机会性内镜筛查始于2004年。我们根据个体特征和萎缩性胃炎患病率调查了胃癌检出率的时间顺序趋势。
方法：总的来说，在2004年2月至2017年12月期间，15,081名年龄≥40岁无胃癌病史的无症状个体在我们研究所接受了首次食管胃十二指肠镜检查。我们回顾性调查了不同时期的个体特征和内镜诊断（早期：2004-2007年，中期：2008-2012年，晚期：2013-2017年），阐明了内镜筛查胃癌的长期检出率和特点,并评价胃癌与萎缩性胃炎的关系。
结果：胃癌的早期检出率，中间,晚期为1.01%(76/7,503,男性/女性:4,360/3,143,平均年龄:59.4岁,萎缩性胃炎的患病率：72％），0.69％（40/5,820，男性/女性：3,668/2,152，平均年龄：56.8岁，萎缩性胃炎的患病率：48％），和0.46％（8/1,758，男性/女性：1,083/675，平均年龄：58.7岁，萎缩性胃炎的患病率：37％），分别。多因素分析显示，男性性别(比值比1.92，95%置信区间1.28-2.95)，年龄≥75岁（2.73，95%CI1.32-5.05），和萎缩性胃炎(C1-C3:2.21,1.36-3.73,O1-O3:5.36,3.17-9.30)与胃癌的发病率显著相关。
结论：随着时间的推移，胃癌检出率和萎缩性胃炎患病率均有所下降。然而,继续进行内窥镜检查很重要，特别是对于那些患有严重萎缩性胃炎的胃癌高风险患者。
方法：总的来说，在2004年2月至2017年12月期间，15,081名年龄≥40岁无胃癌病史的无症状个体在我们研究所接受了首次食管胃十二指肠镜检查。我们回顾性调查了不同时期的个体特征和内镜诊断（早期：2004-2007年，中期：2008-2012年，晚期：2013-2017年），阐明了内镜筛查胃癌的长期检出率和特点,并评价胃癌与萎缩性胃炎的关系。
结果：胃癌的早期检出率，中间,晚期为1.01%(76/7,503,男性/女性:4,360/3,143,平均年龄:59.4岁,萎缩性胃炎的患病率：72％），0.69％（40/5,820，男性/女性：3,668/2,152，平均年龄：56.8岁，萎缩性胃炎的患病率：48％），和0.46％（8/1,758，男性/女性：1,083/675，平均年龄：58.7岁，萎缩性胃炎的患病率：37％），分别。多因素分析显示，男性性别(比值比1.92，95%置信区间1.28-2.95)，年龄≥75岁（2.73，95%CI1.32-5.05），和萎缩性胃炎(C1-C3:2.21,1.36-3.73,O1-O3:5.36,3.17-9.30)与胃癌的发病率显著相关。
结论：随着时间的推移，胃癌检出率和萎缩性胃炎患病率均有所下降。然而,继续进行内窥镜检查很重要，特别是对于那些患有严重萎缩性胃炎的胃癌高风险患者。
