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To assess the validity of mass screening tests for gastric cancer conducted with three types of radiographic techniques, i.e., photofluorography by a mirror camera, photofluorography by an image intensifier, and direct radiography, 105,122 persons who underwent a total of 272,667 screening tests during 1970 through 1982 were followed through December 31, 1983 by means of a record linkage to the Osaka Cancer Registry, Osaka, Japan. The results of 1 year's follow-up from screening were defined as the gold standard and test performance values were calculated. Sensitivity of screening with photofluorography by a mirror camera, photofluorography by an image intensifier, and direct radiography was 90%, 89%, and 91%, and specificity was 86%, 92%, and 91%, respectively. The receiver operating characteristics curve for screening with photofluorography by an image intensifier resembled that for direct radiography and these two curves were located somewhat to the left of the curve for screening with photofluorography by a mirror camera. The authors conclude that the validity of screening with photofluorography by an image intensifier is almost equivalent to that of screening with direct radiography and both are superior to that of screening with photofluorography by a mirror camera.

Periodic checkup by ultrasonography was conducted on patients with chronic liver diseases for early detection of hepatocellular carcinoma. in 19 months, a total of 2004 examinations were performed on a total of 660 cases (179 cases with liver cirrhosis in the compensatory stage, younger than 70 years; 481 cases with chronic hepatitis, aged 40 to 70 years for men and 50 to 70 years for women). of the 660 cases, 22 HCC cases (3.3%) were detected and finally diagnosed by angiography and/or histologic examination. Four of those cases (18%) had a single nodule smaller than 1 cm in diameter, and 11 cases (50%) had a single nodule smaller than 2 cm. Surgical resection was performed on 12 cases (55%). in comparison with the control group (83 HCC cases not receiving any periodic checkup), the frequency of small liver cancer and the surgical resection rate in the study group were significantly higher. This examination system by periodic ultrasonography checkup of patients with chronic hepatic diseases was effective for early detection and permitted aggressive therapy of hepatocellular carcinoma.

This report is based on 1,139 patients with gastric cancer (GC) detected by mass screening conducted by the Center for Adult Diseases, Osaka during 1961-1985. Early GC totalled 527 patients and advanced GC totalled 612 patients. In 859 patients curative resection was performed. Their vital status was traced yearly and six patients were lost to follow-up. Relative survival rates of screening-detected GC patients were 69-70% and almost constant after 5 years from operation/diagnosis. The survival curve in which only death from GC was counted as a death was almost equal to the relative survival curve in its shape and value. The hazard rates of screening detected GC patients decreased rapidly within 7 years and remained low after 7 years. It was confirmed by this long-term follow-up study that about two thirds of GC patients detected by screening were successfully cured of their disease.