Outcomes and Efficiency of National Gastric Cancer Screening Program in Korea

ABSTRACT

BACKGROUND/AIMS: The National Cancer Screening Program (NCSP) for Medicaid recipients has contributed to reduction of cancer-related mortality in Korea. Although biennial gastric cancer screening by endoscopy has been increasing in Korea as part of the NCSP, few studies have evaluated its efficiency. Therefore, we analyzed the outcomes and efficiency of the NCSP for gastric cancer using endoscopy in Korea. MATERIALS AND METHODS: We reviewed results from the NCSP for gastric cancer at Chung-Ang University Yong-San Hospital in Korea from March 2003 to March 2008. The study population comprised of Medicaid recipients more than 40 years old, who were taken from the National Health Insurance Corporation. RESULTS: A total of 7,278 asymptomatic subjects underwent endoscopy for gastric cancer screening. The mean age of the screened subjects was 51.3 years for men and 48.9 years for women. The male to female ratio of the screened subjects was 1.21. Gastric cancer was diagnosed in 32 (0.44%) of 7,278 subjects (22 men and 10 women). Their mean age was 54.4 years. Of these, 21 subjects (0.29%) were diagnosed as early gastric cancer (EGC) and 11 subjects (0.15%) were diagnosed as advanced gastric cancer. The proportion of EGCs among total gastric cancers was 65.6%. CONCLUSIONS: Despite accomplishments of the NCSP for gastric cancer in Korea, its effectiveness remains an issue. Efficiency and cost-effectiveness analysis will be needed for successful progression.