Show simple item record

dc.contributor.authorVohlonen I
dc.contributor.authorHärkönen M
dc.contributor.authorMalila N
dc.contributor.authorPukkala E
dc.contributor.authorSipponen P
dc.contributor.authorKoistinen V
dc.contributor.authorHakama M
dc.date.accessioned2017-10-30T12:13:54Z
dc.date.available2017-10-30T12:13:54Z
dc.date.issued2017
dc.identifier.urihttps://erepo.uef.fi/handle/123456789/4429
dc.description.abstractBackground: Objective was to quantify biases in screening for gastric cancer when comparing attenders to nonattenders using serum pepsinogen I (SPGI) level as primary test. Methods: In mid 1990s, all men aged 51–65 years from two Finnish cities were invited to SPGI screening. Mortality and premature mortality in attenders were compared to nonattenders. Efficacy of screening was studied by 15 years’ follow-up of standardized mortality ratio (SMR) and potential years of life lost (PYLL) due to gastric cancer. Bias due to selective attendance was quantified using corrective coefficients based on total cancer incidence and mortality, and gastric cancer-specific incidence and mortality for total population and nonattenders. Results: In 1994–1996, men aged 51–65 years (16,872) were invited to SPGI assay and 12,175 men (72%) attended. SPGI was 25 microg/l or less in 610 (5%) men, indicating severe atrophic gastritis (AG). Post-screening gastroscopy was performed to 435 men with low SPGI. Of these, 168 men were referred for treatment due to abnormal focal lesions. Attributable proportions in reductions of SMR and PYLL from gastric cancer due to screening were 59% and 67%. After correcting for selective participation, attributable proportions were reduced to 23% and 39%. Conclusions: Biomarker screening by low SPGI among middle-aged men followed by upper gastrointestinal endoscopy decreased long-term and premature mortality due to gastric cancer. However, in spite of methodological corrections done, the results do not justify any firm conclusions or recommend general screening programs. Randomized trials are warranted for this purpose.en
dc.language.isoENen
dc.publisherInforma UK Limiteden
dc.relation.ispartofseriesACTA ONCOLOGICAen
dc.relation.urihttp://dx.doi.org/10.1080/0284186X.2016.1278304en
dc.rightsCC BY-NC-ND https://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectSPGIen
dc.subjectserum pepsinogen Ien
dc.subjectAG: atrophic gastritisen
dc.subjectSMR: standardized mortality ratioen
dc.subjectSIR: standardized incidence ratioen
dc.subjectPYLL: potential years of life losten
dc.titleChallenges in evaluation of screening for gastric cancer among men based on nonrandomized designen
dc.description.versionpublished versionen
dc.contributor.departmentSchool of Medicine / Public Healthen
uef.solecris.id47013337en
dc.type.publicationinfo:eu-repo/semantics/articleen
dc.rights.accessrights© Authorsen
dc.relation.doi10.1080/0284186X.2016.1278304en
dc.description.reviewstatuspeerRevieweden
dc.format.pagerange917-922en
dc.publisher.countryBritanniaen
dc.relation.issn0284-186Xen
dc.relation.issue7en
dc.relation.volume56en
dc.rights.accesslevelopenAccessen
dc.type.okmA1en
dc.type.versioninfo:eu-repo/semantics/publishedVersionen


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record