Hawaii immigrant physical examination

The mortality rate of gastric cancer ranks third in cancer, and the global five-year survival rate is only 10%. The five-year survival rate of gastric cancer patients in China is 20%, which is higher than the global average. But compared with the five-year survival rate of 80% in Japan, there is still a big gap.

First of all, the research shows that the key reason for this difference is that the early diagnosis policies of gastric cancer in the two countries are different.

Looking up the 20 15 version of Japanese gastric cancer screening guidelines, we can know that the recommended starting age of screening in Japan is 50 years old, and the screening interval is set at 2-3 years. It is reported that about150,000 cases of gastroscopy are completed in Japan every year. The population of Japan is 65.438+0.27 billion; In other words, about 1 1% people go for gastroscopy every year; In other words, a national gastroscopy can be completed every ten years on average. This is due to Japan's inclusion of gastroscopy in the compulsory examination items for nationals over 40 years old.

Due to the large population base in China, the existing medical system cannot support gastroscopy; If all the census is completed, it will take about sixty years. So what China is advocating now is to screen high-risk groups in advance. According to Expert Opinions on Early Gastric Cancer Screening Process in China (draft for comment), people over 40 years old who meet any of the following conditions are recommended to be screened for high-risk population of gastric cancer: (1) people in areas with high incidence of gastric cancer; (2) Helicobacter pylori infection; (3) Previous precancerous diseases such as chronic atrophic gastritis, gastric ulcer, gastric polyp, postoperative gastric remnant, hypertrophic gastritis and pernicious anemia; (4) First-degree relatives of patients with gastric cancer; (5) There are other high risk factors for gastric cancer (high salt, pickled diet, smoking, heavy drinking, etc. ).

But in fact, one is due to propaganda reasons; There is also the immature concept of people; Even for some high-risk groups, is there any timely screening?

Secondly, there are differences in screening techniques. At present, Japan has basically given up upper gastrointestinal radiography and directly used endoscopy as the main screening method. In China, the primary screening mainly depends on serological examination, including PG test, Hp test, serum gastrin 17 test and risk score combined with age and gender factors. Check further according to the score. However, endoscopy has not been widely used as a screening method because it depends on the resources of equipment and endoscopists, and its cost is relatively high and painful. In general, only when the risk score is high/medium risk population will further endoscopic examination be carried out.

Therefore, due to China's large population, uneven distribution of medical resources and high cost of endoscopy, it is not feasible to spend a lot of time, manpower and financial resources to conduct a large-scale census.