Abstract

Cancer is a major public health concern. Current estimates suggest that approximately 3 out of every 10 people will be diagnosed with cancer at some point during their lifetime. The American Cancer Society (ACS) estimates that about 1.25 million people in the US will be diagnosed with cancer each year, with nearly 550,000 subsequent deaths. The financial burden of cancer and cost in human lives is staggering. In 1990,it was estimated that the economic burden from cancer in the US was $104 billion: $35 billion for direct costs of prevention, diagnosis and treatment; $12 billion for morbidity costs (economic losses caused by days lost from productive activity because of illness-related disability); and $57 billion in mortality costs (lost economic output measured by loss in earnings because of premature death of productive individuals).

Abstract

Gastric cancer, if diagnosed at the symptomatic stage, has a poor prognosis, with an overall 5 year survival of about 5%. The surgical treatment of early gastric cancer increases this 5-year survival rate to 90%. In Japan, endoscopic surveillance has increased the proportion of gastric cancer detected at an early stage from 15% in 1960 to 50% in 1985, and the overall 5 year survival has been increased from 35% to 70%. Mass screening in Japan is worthwhile because the incidence of gastric cancer is about 80 cases per 100,000 population per annum (age standardized). But in other countries where the incidence is much lower the case for mass screening is weak and selective screening of those at high risk is advocated.