Two Years' Intensive Training in Endoscopic Diagnosis Facilitates Detection of Early Gastric Cancer

Tetsuro Yamazato, Tsuneo Oyama, Toshifumi Yoshida, Yasumasa Baba, Kohei Yamanouchi, Yoshitomo Ishii, Fumio Inoue, Shuji Toda, Kotaro Mannen, Ryo Shimoda, Ryuichi Iwakiri, Kazuma Fujimoto
2012 Internal medicine (Tokyo. 1992)  
Objective Early detection of gastric cancer by screening endoscopy facilitates endoscopic treatment in place of open surgery. The aim of this study was to evaluate whether 2 years intensive training improved the detection of gastric cancer by screening endoscopy. Methods An endoscopist who had trained for 6 years as a general physician, performed screening endoscopy at Imari Arita Kyoritsu Hospital before (group I) and after (group II) intensive training in the diagnosis of early gastric cancer
more » ... arly gastric cancer in consecutive patients. Results Background characteristics, including age (61.6 vs. 62.2 years) and sex, did not differ between the groups. Before training, 10 gastric neoplasms were detected in 937 patients in group I: four early gastric cancers, one gastric adenoma, and five advanced gastric cancer. After training, 36 gastric neoplasms were detected in 937 patients in group II: 18 early gastric cancers, 11 gastric adenoma, five advanced gastric cancer, and one each of gastric carcinoid and malignant lymphoma. The detection rate for early gastric cancer was significantly improved by training [group I: 4/937 (0.4%) vs. group II: 18/937 (1.9%)], although the detection rate for advanced gastric cancer did not differ before and after training. The proportion of early gastric cancer + adenoma to advanced cancer was higher in group II (5/5 vs. 29/5 in group I). Conclusion Intensive training in upper gastrointestinal endoscopy screening dramatically improved the detection rate for early gastric cancer, although the detection rate for advanced gastric cancer was not affected. .7414) Recent significant progress in endoscopy, including narrow band imaging, Fuji intelligent color enhancement, auto fluorescence imaging and infra-red imaging has improved endoscopic diagnosis but not the overall detection rate of early gastric cancer, because, in Japan, most early gastric cancer is detected by white light endoscopy. One previous study has indicated that the colon adenoma detection rate
doi:10.2169/internalmedicine.51.7414 pmid:22728475 fatcat:dzhibz5zunaajhwuq76oh6u6cy