Eradication of gastric cancer and more efficient gastric cancer surveillance in Japan: two peas in a pod
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We provide a historical review and update on current thinking regarding the possibility of elimination of gastric cancer from Japan. Because Helicobacter pylori infection is the cause gastric cancer, its elimination forms the cornerstone of eradication of gastric cancer. However, simply eradicating H. pylori from the entire population will not immediately solve the problem because many patients with H. pylori infections have already developed the precursor lesion, atrophic gastritis. Cure of H. pylori in these high risk patients will only reduce the risk of subsequent cancer. In contrast, treatment of low risk patients will prevent cancer. Thus, to eliminate gastric cancer it is necessary to identify and treat all infected individuals. In addition, those at increased risk for gastric cancer (i.e., atrophic gastritis irrespective of age) should be considered for endoscopic surveillance to identify those cancers that develop at an early stage. We propose that severity and extent of atrophy be used to separate those expected to benefit from endoscopy and annual surveillance from those with little or no potential benefit. We suggest an algorithm for eradicating gastric cancer that incorporates H. pylori and atrophic gastritis testing, H. pylori therapy, and surveillance to institute a program of surveillance restricted to those who could benefit most (i.e., those with moderate or severe atrophy). This will also allow a much closer matching of surveillance capacity and surveillance need making surveillance more clinically- and cost-effective.
- Graham DY, Lu H, Yamaoka Y. African, Asian or Indian enigma, the East Asian Helicobacter pylori: facts or medical myths. J Dig Dis. 2009;10:77–84. CrossRef
- Hoffman FL. The mortality from cancer throughout the world. Newark: Prudential Press; 1915.
- von den Velden R. Ueber vorkommen und mandgel der freien salzsaure in magensaft bei gastrektasie. Deutsches Arch Klin Med. 1879;23:369–99.
- Faber K. Gastritis and its consequences. Paris: Oxford University Press; 1935.
- Comfort MW. Gastric acidity before and after development of gastric cancer: its etiologic, diagnostic and prognostic significance. Ann Intern Med. 1951;36:1331–48.
- Warren RJ, Marshall BJ. Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet. 1983;1:1273–5.
- Comfort MW, Vanzant FR. Gastric acidity in carcinoma of the stomach. Am J Surg. 1934;26:447–56. CrossRef
- Shay H, Gershon-Cohen J, Fels SS. Gastric anacidity: its physiologic and clinical significance and its management. Am J Dig Dis. 1941;8:115–23.
- Berkson J, Butt HR, Comfort MW. Occurrence of gastric cancer in persons with achlorhydria and with pernicious anemia. Proc Staff Meet Mayo Clin. 1956;31:583–96.
- Faber K. Chronic gastritis: its relation to achylia and ulcer. Lancet. 1927;2:902–7.
- Massarrat S. Konjetzny: a German surgeon of the past century and his pioneering hypothesis of a bacterial aetiology for gastritis, peptic ulcer and gastric cancer. Z Gastroenterol. 2005;43:411–3. CrossRef
- Cheli R, Perasso A, Giacosa A. Gastritis: a clinical review. Berlin: Springer; 1987.
- Correa P, Haenszel W, Cuello C, Tannenbaum S, Archer M. A model for gastric cancer epidemiology. Lancet. 1975;2:58–60. CrossRef
- Kokkola A, Kosunen TU, Puolakkainen P, Sipponen P, Harkonen M, Laxen F, et al. Spontaneous disappearance of Helicobacter pylori antibodies in patients with advanced atrophic corpus gastritis. APMIS. 2003;111:619–24. CrossRef
- Weck MN, Gao L, Brenner H. Helicobacter pylori infection and chronic atrophic gastritis: associations according to severity of disease. Epidemiology. 2009;20:569–74. CrossRef
- Ekstrom AM, Held M, Hansson LE, Engstrand L, Nyren O. Helicobacter pylori in gastric cancer established by CagA immunoblot as a marker of past infection. Gastroenterology. 2001;121:784–91. CrossRef
- Graham DY, Sung JY. Helicobacter pylori. In: Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease. Pathophysiology, diagnosis, management. 7th ed. Philadelphia: WB Saunders; 2006. p. 1049–66.
- Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol. 2006;163:127–34. CrossRef
- Dholakia KR, Dharmarajan TS, Yadav D, Oiseth S, Norkus EP, Pitchumoni CS. Vitamin B12 deficiency and gastric histopathology in older patients. World J Gastroenterol. 2005;11:7078–83.
- DuBois S, Kearney DJ. Iron-deficiency anemia and Helicobacter pylori infection: a review of the evidence. Am J Gastroenterol. 2005;100:453–9. CrossRef
- Hershko C, Lahad A, Kereth D. Gastropathic sideropenia. Best Pract Res Clin Haematol. 2005;18:363–80. CrossRef
- Tan HJ, Goh KL. Changing epidemiology of Helicobacter pylori in Asia. J Dig Dis. 2008;9:186–9.
- Graham DY. Helicobacter pylori infection in the pathogenesis of duodenal ulcer and gastric cancer: a model. Gastroenterology. 1997;113:1983–91. CrossRef
- Ohata H, Kitauchi S, Yoshimura N, Mugitani K, Iwane M, Nakamura H, et al. Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer. Int J Cancer. 2004;109:138–43. CrossRef
- Snaith A, El-Omar EM. Helicobacter pylori: host genetics and disease outcomes. Expert Rev Gastroenterol Hepatol. 2008;2:577–85. CrossRef
- Graham DY, Uemura N. Natural history of gastric cancer after Helicobacter pylori eradication in Japan: after endoscopic resection, after treatment of the general population, and naturally. Helicobacter. 2006;11:139–43. CrossRef
- Graham DY, Shiotani A. The time to eradicate gastric cancer is now. Gut. 2005;54:735–8. CrossRef
- Graham DY, Shiotani A, El-Zimaity HM. Chromoendoscopy points the way to understanding recovery of gastric function after Helicobacter pylori eradication. Gastrointest Endosc. 2006;64:686–90. CrossRef
- Graham DY. Gastric cancer surveillance or prevention plus targeted surveillance. Jpn J Helicobacter Res. 2009;10:9–14.
- Rugge M, Correa P, Di Mario F, El-Omar E, Fiocca R, Geboes K, et al. OLGA staging for gastritis: a tutorial. Dig Liver Dis. 2008;40:650–8. CrossRef
- Graham DY, Kato M, Asaka M. Gastric endoscopy in the 21st century: appropriate use of an invasive procedure in the era of non-invasive testing. Dig Liver Dis. 2008;40:497–503. CrossRef
- Miki K, Morita M, Sasajima M, Hoshina R, Kanda E, Urita Y. Usefulness of gastric cancer screening using the serum pepsinogen test method. Am J Gastroenterol. 2003;98:735–9. CrossRef
- Urita Y, Hike K, Torii N, Kikuchi Y, Kanda E, Sasajima M, et al. Serum pepsinogens as a predicator of the topography of intestinal metaplasia in patients with atrophic gastritis. Dig Dis Sci. 2004;49:795–801. CrossRef
- El-Zimaity HM, Ota H, Graham DY, Akamatsu T, Katsuyama T. Patterns of gastric atrophy in intestinal type gastric carcinoma. Cancer. 2002;94:1428–36. CrossRef
- Oi M, Oshida K, Sugimura S. The location of gastric ulcer. Gastroenterology. 1959;36:45–56.
- Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy. 1969;1:87–97. CrossRef
- Kimura K. Chronological transition of the fundic-pyloric border determined by stepwise biopsy of the lesser and greater curvatures of the stomach. Gastroenterology. 1972;63:584–92.
- Hebbel R. The topography of chronic gastritis in otherwise normal stomachs. Am J Pathol. 1949;25:125–41.
- Watabe H, Mitsushima T, Yamaji Y, Okamoto M, Wada R, Kokubo T, et al. Predicting the development of gastric cancer from combining Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study. Gut. 2005;54:764–8. CrossRef
- Fukase K, Kato M, Kikuchi S, Inoue K, Uemura N, Okamoto S, et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial. Lancet. 2008;372:392–7. CrossRef
- Cancer incidence and incidence rates in Japan in 1986: estimates based on data from nine population-based cancer registries. The Research Group for Population-based Cancer Registration in Japan. Jpn J Clin Oncol. 1991;21:318–23.
- Eradication of gastric cancer and more efficient gastric cancer surveillance in Japan: two peas in a pod
Journal of Gastroenterology
Volume 45, Issue 1 , pp 1-8
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- Springer Japan
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- Gastric cancer
- Helicobacter pylori
- Natural history
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