Yoshinaru Uno, MD, PhD

簡単に説明しよう。

日本の研究者は、不確かなデータを基に、

国会にまで持ち出して、

ピロリ菌治療によって、胃癌の発生を抑制し、胃癌死亡を減らすと言い続けた。

一方、韓国では、それを肯定する派と、否定する派が存在した。

そして、否定派は、胃内視鏡検査でスクリーニングする方法での結果を示した。

ピロリ菌の有無や除菌の介入にかかわらず、、

毎年、内視鏡検査を行うだけで、胃癌死亡がどんどん減るというデータが公開された。

Gastroenterology. 2017 May;152(6):1319-1328.e7. doi: 10.1053/j.gastro.2017.01.029. Epub 2017 Jan 29.

Effectiveness of the Korean National Cancer Screening Program in Reducing Gastric Cancer Mortality.

Jun JK1, Choi KS2, Lee HY3, Suh M4, Park B1, Song SH4, Jung KW4, Lee CW5, Choi IJ6, Park EC7, Lee D1.

Author information

Abstract

BACKGROUND & AIMS:

It is not clear whether screening for gastric cancer by upper endoscopy or upper gastrointestinal (UGI) series examinations (looking at the upper and middle sections of the gastrointestinal tract by imaging techniques) reduces mortality. Nevertheless, the Korean National Cancer Screening Program for gastric cancer was launched in 1999 to screen individuals 40 years and older for gastric cancer using these techniques. We evaluated the effectiveness of these techniques in gastric cancer detection and compared their effects on mortality in the Korean population.

METHODS:

We performed a nested case-control study using data from the Korean National Cancer Screening Program for gastric cancer since 2002. A total of 16,584,283 Korean men and women, aged 40 years and older, comprised the cancer-free cohort. Case subjects (n = 54,418) were defined as individuals newly diagnosed with gastric cancer from January 2004 through December 2009 and who died before December 2012. Cases were matched with controls (subjects who were alive on the date of death of the corresponding case subject, n = 217,672) for year of entry into the study cohort, age, sex, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained via conditional logistic regression analysis.

RESULTS:

Compared with subjects who had never been screened, the overall OR for dying from gastric cancer among ever-screened subjects was 0.79 (95% CI, 0.77-0.81). According to screening modality, the ORs of death from gastric cancer were 0.53 (95% CI, 0.51-0.56) for upper endoscopy and 0.98 (95% CI, 0.95-1.01) for UGI series. As the number of endoscopic screening tests performed per subject increased, the ORs of death from gastric cancer decreased: 0.60 (95% CI, 0.57-0.63), 0.32 (95% CI, 0.28-0.37), and 0.19 (95% CI, 0.14-0.26) for once, twice, and 3 or more times, respectively.

CONCLUSIONS:

Within the Korean National Cancer Screening Program, patients who received an upper endoscopy were less likely to die from gastric cancer; no associations were found for UGI series

2018年、韓国の肯定派は、ピロリ菌除菌で胃癌発症が半数に減少すると報告した。

Choi IJ, Kook MC, Kim YI, et al. Helicobacter pylori Therapy for the Prevention of Metachronous Gastric Cancer. N Engl J Med. 2018;378:1085-1095.

それに対し、韓国の否定派から、胃癌による死亡数は同等であり、

除菌群では全死亡数が増加していると指摘した。

Kim YH, Shin SW. Helicobacter pylori and Prevention of Gastric Cancer. N Engl J Med. 2018;378:2244.

一方、韓国のような活発な意見がない日本では、

胃癌の発生数は増加し続け、

胃癌死亡数にしても減少数は、全く予定のようにならず、

ピロリ菌除菌後の胃癌が増加してきていることに狼狽し、

除菌者では毎年の胃内視鏡の検査が必要だと臨床医が言い出した。

（これは、現場からの悲鳴である）

であれば、除菌費用1000億円以上をかげずとも、韓国の方法（内視鏡だけ）でいい話である。

この敗北を国辱として、

その誤りを、正直に、世界に発信しなければ、

歴史的に、日本国の恒久的な恥となる、と私は思っている。