Gastric Cancer Screening Quality Improvement System Establishment

Study Overview
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Brief Summary
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Experienced endoscopists will perform endoscopy during the study period and the detection rate of gastric premalignant lesion, correlation between endoscopic and serologic diagnosis of premalignant lesions and inter-observer agreement rate will be analyzed before and after the education.

Detailed Description
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This study is an extension of quality assurance program in Seoul National University Hospital Healthcare System Gangnam Center. This study is composed of four periods. First, the detection rate of gastric premalignant lesions and the correlation between endoscopic and serologic diagnosis of premalignant lesions will be analyzed retrospectively from March 2008 till February 2009 and from March 2013 till February 2014, when the levels of serum pepsinogen were achieved from the patients. In the second period from March 2015 till April 2015, quality assurance program will be activated. Endoscopists will be educated on the Kimura-Takemoto classification for chronic atrophic gastritis. After that their diagnosis will be tested and they will have feedback and discussion all together. In this period, inter-observer agreement rate will be assessed serially. Third, prospective trial will run from May 2015 till April 2020, in which all the endoscopists' detection rate of gastric premalignant lesion, the correlation between endoscopic and serologic diagnosis of premalignant lesions, and their inter-observer agreement will be analyzed. Finally, cumulative incidence and mortality rate of gastric cancer and incidence rate of gastric dysplasia will be investigated until December 2020.

Official Title
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A Prospective Cohort Study for Development of Korean Gastric Cancer Prediction Model and Tailored Gastric Cancer Screening Program

Conditions
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Gastric Cancer, Gastritis, Atrophic, Intestinal Metaplasia

Intervention / Treatment
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* Behavioral: Education and feedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who received endoscopy in Seoul National University Hospital Healthcare System Gangnam Center from 2008 till 2020. Exclusion Criteria: Age < 18 years Those who refused to be included in the research History of gastric cancer Current medication with proton pump inhibitor, non-steroidal anti-inflammatory drug or aspirin Active/healing stage of gastric ulcer or gastric ulcer scar Active/healing stage of duodenal ulcer History of previous surgical or endoscopic resection of stomach

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experienced endoscopists<br>All the experienced endoscopists will receive education and feedback on the diagnosis for premalignant lesion of chronic atrophic gastritis and intestinal metaplasia | Behavioral: Education and feedback<br>* Experienced endoscopists will receive education on Kimura-Takemoto classification and feedback for their answers for classification tests.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Detection rate for gastric premalignant lesion |  | 7 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between endoscopic and serologic diagnosis of premalignant lesions |  | 7 years | 
| Inter-observer agreement rate for the diagnosis of premalignant lesions |  | 2 months | 
| Detection rate for gastric cancer |  | 7 years | 
| Detection rate for gastric dysplasia |  | 7 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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gastric cancer, chronic atrophic gastritis, intestinal metaplasia