Performance profile of a FDG-PET cancer screening program for detecting gastric cancer: results from a nationwide Japanese survey

Purpose It has been reported that gastric cancer is the sixth most common cancer found during the 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) cancer screening program, which is defined as cancer screening of asymptomatic subjects using FDG-PET(/CT) (in combination with other screening tests or not). The aim of this study was to analyze the detection rate and the effectiveness of the FDG-PET cancer screening program at detecting gastric cancer between 2006 and 2009 in Japan. Materials and methods A total of 153,775 asymptomatic subjects (92,255 men, 61,520 women) between 30 and 80 years old underwent the FDG-PET cancer screening program. Of these, we analyzed 790 cases with findings of possible gastric cancer in any screening test. Results The number of cases who were verified to have gastric cancer was 124. Among these, only 47 cases were detected by FDG-PET, which resulted in a relative sensitivity of 37.9 % and a positive predictive value of 33.6 %. The relative sensitivity of FDG-PET was much lower than those of gastric endoscopy and the serum pepsinogen test. Conclusion The FDG-PET screening program in Japan detected some cases of early-stage gastric cancer, but this was not achieved using FDG-PET alone but in combination with gastric endoscopy. Gastric endoscopy should be included in FDG-PET cancer screening programs to screen for gastric cancer.