OBJECTIVES: Although the effectiveness of endoscopic screening for gastric cancer has been shown in Korea, China, and Japan, the screening interval varies. The optimal screening interval was investigated based on the stage distribution of screen-detected gastric cancer. The optimal screening interval of endoscopic screening for gastric cancer was investigated according to the stage distribution of gastric cancer as well as survival rates of patients with screen-detected gastric cancers using the Niigata City Medical Association database.

METHODS: Patients with gastric cancer detected by endoscopic and radiographic screenings were selected from the Niigata City Medical Association database. The stage distribution of the detected gastric cancers was compared among patients with different screening histories in both screening groups. Gastric cancer specific survival rates were analyzed using the Kaplan-Meier method with the log-rank test.

RESULTS: There were 1,585 and 462 subjects in the endoscopic and radiographic screening groups, respectively. In the endoscopic screening group, the stage IV proportion was lower in patients with screening history 1 and 2 years previously than in patients without screening history. Although stage IV development was related to the absence of endoscopic screening history (p < 0.001), there were no differences between patients who had screening history 2 and 3 years previously. The survival rates were not significantly different between patients with endoscopic screening 1 and 2 years previously (p = 0.7763). The survival rates were significantly higher in patients with screening history than in patients without screening history (p < 0.001), and in patients with endoscopic screening 3 years previously (p = 0.0069).

CONCLUSIONS: The endoscopic screening interval for gastric cancer can be expanded to at least 2 years based on the stage distribution of detected cancers and the patient survival rates.