OBJECTIVES: The effectiveness of endoscopic screening for gastric cancer has been continually evaluated; however, only a few studies have reported its effectiveness. Notably morality reduction from cancer screening has not yet been rigorously evaluated in survival analyses, but an important requirement for cancer screening is improving survival. We performed survival analysis for gastric cancer detected by endoscopic screening and compared the results with those of survival analysis for gastric cancer detected by radiographic screening and outpatients. METHODS: The subjects of our study were selected from gastric cancer cases registered in 4 cities in the Tottori Cancer Registry from 2001 to 2006. The target age group was defined as the age in which gastric cancer was diagnosed from 40 to 79 years. Follow-up was continued from the date of diagnosis to the time death from gastric cancer or up to December 31, 2011. The survival of 3 groups at 5 and 10 years were compared using the Kaplan-Meier method with the log-rank test. RESULTS: There were 347 subjects selected for endoscopic screening, 166 for radiographic screening, and 980 as outpatients. The 5-year survival rates were follows: 91.2 ± 1.5% (95% CI: 87.6-93.8) for endoscopic screening, 84.3 ± 2.9% (77.7-89.1) for radiographic screening, and 66.0 ± 1.6% (62.8-68.9) for outpatients. The 10-year survival rates were follows: 88.5 ± 2.0% (83.9-91.9) for endoscopic screening, 80.1 ± 3.6% (71.9-86.2) for radiographic screening, and 64.6 ± 1.6% (61.3-67.6) for outpatients. The survival rates were significantly different in the 3 groups (P < 0.001). CONCLUSIONS: The survival rate was higher for endoscopic screening than those for radiographic screening and outpatients. Since a high survival rate is mainly affected by lead–time bias, the effectiveness of endoscopic screening should be further evaluated in term of mortality reduction by conducting large-scale and reliable studies.