Objective To evaluate the importance of clinical screening and follow-up by direct gastroscopy for gastric cancer at an early and curable stage. Methods There were 3 048 elderly people aged from 60 to 93 years. The clinical screening by direct gastroscopy was performed according to the protocol. Some 2 034 of 3 048(66.7%) patients were followed up every year. Results Ninety-two were found to be gastric cancer patients by gastroscopy, with detectable rate being 3.0%. Fifty-eight were diagnosed to have early gastric cancer, which accounted for 63.0% of the detected gastric cancer. Thirty-nine among the 49 followed-up cases(79.6%) were detected gastric cancer. The resectable rate was 88.9% for gastric cancer, and 100.0% for early gastric cancer. 5-year survival rate was 91.9% for gastric cancer, and 96.3% for early gastric cancer. The incidence of complication for gastroscopy was 0.097%. Conclusions The clinical screening and follow-up by direct gastroscopy for persons over 60 years is safe and effective method for the diagnosis of gastric cancer. It could increase the 5-year survival rate, especially for early gastric cancer.%目的通过对老年人进行胃镜普查及随访，提高老年人胃癌的防治水平。方法结合每年查体对3 048例60～93岁老年人进行胃镜普查，胃镜随访2 034例, 随访率为66.7%。结果共检出胃癌92例，检出率为3.0%，其中早期胃癌58例，占63.0%；胃镜随访中检出早期胃癌39例，占随访检出胃癌49例的79.6%。胃癌、早期胃癌的手术切除率为88.9%及100.0%，5年生存率分别为91.9%及96.3%。胃镜检查并发症的发生率为0.097%。结论开展胃镜普查及随访是提高老年人早期胃癌诊断率及胃癌术后5年生存率的安全可靠方法。
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