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Objective: Estimates of lead time (LT), i.e., from detection of cancer in asymptomatic persons to manifestations of the disease, can be obtained by follow-up of populations at risk, reviews of the past histories of patients with cancer, estimates of tumor doubling time, and from the ratio between the prevalence of cancer at the first round of screening and its annual incidence on subsequent screening rounds. Aim of this study is to derive the LT of gastric cancer (GC) from published studies.
Material and Methods: An overview of longitudinal studies and screening trials of GC; search of the reference sections of the retrieved papers for additional relevant studies; and calculation of the LT derived from these studies.
Results: LT was 2.8 – 7.3 years if derived from prospective follow-up studies; 1.0 - 4.0 years if derived from retrospective reviews of the patients' histories before the clinical diagnosis of GC; 5.9 - 8.6 years if derived from tumor doubling time; and 1.8 - 4.3 years if derived from prevalence / /incidence ratios.
Conclusions: There is wide variability in estimates of the LT of GC. Since an LT exceeding 6 six years may explain the improved survival of patients with screen-detected GS, the present survey does not obviate the need for randomized clinical trials of the effect of screening on gastric cancer mortality.
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