The Impact of High-Density Barium Use in Double Contrast Radiographic Methods for Gastric Cancer Screening in Niigata, Japan
SHIZUKO WAKAI, NAOHITO TANABE1 and HIROSHI SUZUKI
Division of Public Health, Department of Infectious Disease Control and International Medicine, and 1Division of Health Promotion, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
Use of high-density barium (= or > 180 w/v%) has been widely spread in community-based mass screening for gastric cancer in Japan. However, the impact on outcomes of the screening has not been fully evaluated. Then, we investigated the advantage of high-density barium use by comparing the outcomes between a period with high-density barium and that with low-density barium (< 180 w/v%) each for 3 consecutive years between 1991and 2002 at 5 medical examination organizations in Niigata Prefecture, Japan. Multivariate logistic regression analysis adjusted for age, sex and medical organization revealed that the introduction of high-density barium decreases the positive finding rate in initial mass screening x-ray examinations by 12% (odds ratio, 0.88; 95% confidence interval, 0.86 - 0.90) and increase the gastric cancer detection rate by diagnostic examination by 15% (odds ratio, 1.15; 95% confidence interval, 1.01-1.31). We conclude that introduction of high-density barium has improved the efficiency of mass screening for gastric cancer by decreasing unnecessary diagnostic examinations and reducing the total personal and public health costs. Thus, nationwide use of high-density barium is recommended for mass gastric cancer screening in Japan.
keywords —— gastric cancer; mass screening; double contrast indirect radiography; high-density barium; cost effectiveness
© 2005 Tohoku University Medical Press
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Tohoku J. Exp. Med., 2005, 205, 343-349
Correspondence: Naohito Tanabe, Division of Health Promotion, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata City, Niigata 951-8510, Japan.
e-mail: tanabe@med.niigata-u.ac.jp