{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T08:31:57Z","timestamp":1786350717948,"version":"build-2736575974"},"reference-count":60,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Japan Cancer Society Cancer Screening Research Grant"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>\n                    Japan has developed one of the world\u2019s most established population-based gastric cancer screening systems through more than six decades of continuous refinement in public health policy, technological innovation, and quality assurance. This review summarizes the historical development, technological evolution, quality assurance framework, and future perspectives of gastric cancer screening in Japan, while providing comparisons with major gastric cancer screening programs and prevention initiatives worldwide. Japanese gastric cancer screening can be traced to the postwar adaptation of mass tuberculosis radiographic screening systems, followed by the nationwide implementation of double-contrast upper gastrointestinal radiography. Subsequent advances in gastrointestinal endoscopy, including high-resolution imaging, magnifying endoscopy, and image-enhanced endoscopy, have facilitated the transition toward endoscopic screening and improved early gastric cancer detection. Japan has also established highly standardized quality assurance systems, including structured training, credentialing, standardized examination protocols, defined quality indicators, and continuous program monitoring of screening performance. These efforts have supported the standardization and continuous quality improvement of population-based gastric cancer screening programs. The incidence and risk-factor profile of gastric cancer are changing rapidly because of declining\n                    <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                    prevalence, population aging, and increasing recognition of\n                    <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                    -na\u00efve gastric cancer. Consequently, future screening systems will likely require greater incorporation of personalized risk stratification, optimized allocation of endoscopic resources, and emerging technologies such as artificial intelligence-assisted endoscopy and structured digital quality assurance systems. Japan\u2019s experience provides a valuable case study illustrating how quality assurance, technological innovation, and public health infrastructure can be integrated to support population-based gastric cancer screening.\n                  <\/jats:p>","DOI":"10.1177\/10732748261476091","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T10:35:16Z","timestamp":1786185316000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Population-Based Gastric Cancer Screening in Japan: Evolution, Challenges, and Lessons for Implementation"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4065-7958","authenticated-orcid":false,"given":"Fumiaki","family":"Ishibashi","sequence":"first","affiliation":[{"name":"Showa Medical University Northern Yokohama Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutake","family":"Yamamichi","sequence":"additional","affiliation":[{"name":"The University of Tokyo Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taishi","family":"Okumura","sequence":"additional","affiliation":[{"name":"Showa Medical University Northern Yokohama Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-7371","authenticated-orcid":false,"given":"Chikamasa","family":"Ichita","sequence":"additional","affiliation":[{"name":"Kitasato University School of Medicine, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuro","family":"Ichimasa","sequence":"additional","affiliation":[{"name":"Showa Medical University Northern Yokohama Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Misawa","sequence":"additional","affiliation":[{"name":"Showa Medical University Northern Yokohama Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chika","family":"Kusano","sequence":"additional","affiliation":[{"name":"Kitasato University School of Medicine, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1276-2398","authenticated-orcid":false,"given":"Manami","family":"Inoue","sequence":"additional","affiliation":[{"name":"St. Luke\u2019s International University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Ohtsuka","sequence":"additional","affiliation":[{"name":"Showa Medical University Northern Yokohama Hospital, Kanagawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Gotoda","sequence":"additional","affiliation":[{"name":"Cancer Institute Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,8]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyy077"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28065"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01671151"},{"issue":"6","key":"e_1_3_5_5_2","first-page":"1233","article-title":"Gastric Carcinoma","volume":"32","author":"Maruyama M","year":"1994","unstructured":"Maruyama M, Baba Y. Gastric Carcinoma. Radiol Clin North Am. 1994;32(6):1233-1252.","journal-title":"Radiol Clin North Am"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02256337"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/den.14063"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyn017"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11154337"},{"key":"e_1_3_5_10_2","unstructured":"The Japanese Society of Gastrointestinal Cancer Screening website. https:\/\/www.jsgcs.or.jp\/about\/summary\/history\/. Accessed July 3 2026."},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/cas.12829"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2023.100741"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-016-0659-4"},{"key":"e_1_3_5_14_2","first-page":"11","article-title":"The endoscopic diagnosis of early gastric cancer","volume":"26","author":"Yao K","year":"2013","unstructured":"Yao K. The endoscopic diagnosis of early gastric cancer. Ann Gastroenterol. 2013;26:11-22.","journal-title":"Ann Gastroenterol"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2015.48.6.481"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000334642"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-025-02296-y"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/hel.70052"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.2183\/pjab.87.405"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.31662\/jmaj.2025-0392"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1159\/000548434"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-024-01525-2"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-023-01449-3"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2024.01.022"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.3521"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.055400"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.70217"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyw106"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-018-0793-2"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.855175"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1365524"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2021.101733"},{"key":"e_1_3_5_33_2","first-page":"72","article-title":"A survey and evaluation of population-based screening for gastric cancer","volume":"10","author":"Yuan Y","year":"2013","unstructured":"Yuan Y. A survey and evaluation of population-based screening for gastric cancer. Cancer Biol Med. 2013;10:72-80.","journal-title":"Cancer Biol Med"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.01.029"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2021.482"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.01.028"},{"key":"e_1_3_5_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302240"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/hel.70102"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322200"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.14887"},{"key":"e_1_3_5_41_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2026.6908"},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.06.078"},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-2863-8314"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-318126"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.11.001"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000003350"},{"key":"e_1_3_5_47_2","volume-title":"Council Recommendation on strengthening prevention through early detection: A new EU approach on cancer screening replacing Council Recommendation","unstructured":"Council Recommendation on strengthening prevention through early detection: A new EU approach on cancer screening replacing Council Recommendation. https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/?uri=uriserv%3AOJ.C_.2022.473.01.0001.01.ENG&toc=OJ%3AC%3A2022%3A473%3AFULL. Accessed July 3, 2026."},{"key":"e_1_3_5_48_2","volume-title":"Population-based Helicobacter pylori screen-and-treat strategies for gastric cancer prevention: Guidance on implementation","author":"Park JY","year":"2025","unstructured":"Park JY. Population-based Helicobacter pylori screen-and-treat strategies for gastric cancer prevention: Guidance on implementation. IARC Publications; 2025."},{"key":"e_1_3_5_49_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.18457"},{"key":"e_1_3_5_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00186-X"},{"key":"e_1_3_5_51_2","doi-asserted-by":"publisher","DOI":"10.20892\/j.issn.2095-3941.2022.0655"},{"key":"e_1_3_5_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vhri.2017.04.001"},{"key":"e_1_3_5_53_2","unstructured":"International Cancer Control Partnership (ICCP). Healthy China Initiative (2019-2030): Cancer Prevention and Control Actions. https:\/\/www.iccp-portal.org\/resources. Accessed 20 May 2026."},{"key":"e_1_3_5_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2021.09.017"},{"key":"e_1_3_5_55_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2025.12.020"},{"key":"e_1_3_5_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.07.043"},{"key":"e_1_3_5_57_2","doi-asserted-by":"publisher","DOI":"10.1111\/hel.70121"},{"key":"e_1_3_5_58_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb2515372"},{"key":"e_1_3_5_59_2","unstructured":"National Cancer Center Japan. Cancer Screening Participation Rates. https:\/\/ganjoho.jp\/reg_stat\/statistics\/stat\/screening\/screening.html. Accessed 19 May 2026."},{"key":"e_1_3_5_60_2","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20250021"},{"key":"e_1_3_5_61_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.5995-25"}],"container-title":["Cancer Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748261476091","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10732748261476091","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748261476091","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T08:16:28Z","timestamp":1786349788000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10732748261476091"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":60,"alternative-id":["10.1177\/10732748261476091"],"URL":"https:\/\/doi.org\/10.1177\/10732748261476091","relation":{},"ISSN":["1073-2748","1526-2359"],"issn-type":[{"value":"1073-2748","type":"print"},{"value":"1526-2359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"article-number":"10732748261476091"}}