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KMID : 0614720150580050373
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Journal of Korean Medical Association
2015 Volume.58 No. 5 p.373 ~ p.384
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The Korean guideline for gastric cancer screening
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Park Hyun-Ah
Nam Su-Youn
Lee Sang-Kil
Kim Sang-Gyun
Shim Ki-Nam
Park Sang-Min
Lee Sun-Young
Han Hye-Seung
Shin Yong-Moon
Kim Kyoung-Mee
Lee Kyung-Jae
Lee Tae-Yong
Choi Il-Ju
Hong Seong-Sook
Kim Jae-Woo
Lee Yoon-Jae
Kim Soo-Young
Kim Yeol
Lee Won-Chul
Chung Il-Kwun
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Abstract
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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).
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KEYWORD
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Early detection of cancer, Gastric neoplasms, Guideline, Gastric endoscopy, Upper gastrointestinal series
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