The ability of radiographers to detect cancer on radiographs was compared to that of physicians to assess the competence of radiographers as film readers in gastric cancer screening. After obtaining permission for the screening and analysis of data, a test set of films from 100 patients who underwent gastric cancer screening using radiographic examination was evaluated. Films were selected from 137 744 patients and 197 cases of cancer. Screening was performed at the Osaka Cancer Prevention and Detection Center in Japan between April 2004 and March 2008. Eleven radiographers affiliated to the screening center and 37 physician readers scored the test set on a 4-point scale blinded to the other participants' scores. Receiver operating characteristic (ROC) analysis was performed to evaluate the interpretation performance, and the area under the ROC curve (AUC) was defined as the ability of the radiographer or physician reader to detect cancer. The results showed that the average ability of radiographers to detect cancer (AUC, 0.82) was identical to that of physician readers (p = 0.96, Welch's t test), suggesting that radiographers can assume the role of film readers in gastric cancer screening.