Despite improvements in treatment modalities, gastric cancer is the second cause of mortality among Korean men and third among females in Korea. Korea implemented a gastric cancer screening program for the general population in 1999. However, the effectiveness and harms of gastric cancer screening using gastric endoscopy and upper gastrointestinal (UGI) series have not been fully evaluated. In an effort to evaluate the screening program, the Korean multidisciplinary expert committee for developing a gastric cancer screening guideline systematically reviewed the evidence regarding the benefits and harms of gastric cancer screening, and developed an evidence-based clinical guideline. There is 'low' level evidence that gastric cancer screening using gastric endoscopy or UGI series can reduce gastric cancer mortality for asymptomatic adults aged between 40 to 74 years. The benefits of gastric cancer screening using gastric endoscopy are substantially higher than its harms, while the benefits of screening with UGI series are moderately higher. We recommend that asymptomatic adults from 40 to 75 years of age undergo biannual gastric cancer screening using gastric endoscopy (recommendation B). Gastric cancer screening using UGI series in asymptomatic adults aged between 40 to 74 years may be recommended based on clinicians' judgment regarding the patient's risk and the patient's preference (recommendation C). There is insufficient evidence to assess the benefits and harms of gastric cancer screening for adults aged between 75 to 84 years (recommendation I). We recommend against gastric cancer screening for adults older than 85 years (recommendation D).
Bibliographical noteFunding Information:
Accepted May 31, 1994. Drs. Miller, Piacentini, Klein, and Ms. Samoilov are with the College of Physiciansand StllgeonsofColumbia Universityand New YorkState Psychiatric 1nstitute. Drs. Abikoffand Shah are with Schneider Children 5 Hospital, Long Island jewish Medical Center. Ms. Guardino is with Freedom from Fear, Staten lsiand. NY. lin's research W(/5 supported ill flirt by ,hi' Barbnra JOIl(/S Center fOr tin' Study and Treatment ofChildren at Risk, the Lowenstein Centerfor the Study and Prevention ofDisruptive Disorders, and NIMH grant MH35779 to Dr. Klein. The authorsgratefidly acknowledgethe assistance ofDonald Klein, jacob Cohen, and Mark Davies in the preparation ofthis manuscript. Reprint requests to Dr. Miller, Department ofChild Psychiatry, Columbia University College of Physicians and Surgeons/New York State Psychiatric Institute, 722 West 168th Street, Unit 60, New York, NY 10032. 0890-8567/95/3403-0359$03.00/0© 1995 by the American Academy of Child and Adolescent Psychiatry.
©Korean Medical Association.
All Science Journal Classification (ASJC) codes