Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Though gastric cancer screening by X-ray examination has been confirmed to be effective for reducing gastric cancer mortality, decreases in efficiency have been pointed out. Establishment of an effective screening system, focusing on high-risk status such as Helicobacter pylori infection and atrophic gastritis, is desirable. To date, combined use of serum anti-Helicobacter pylori antibodies and pepsinogen measurement has been assessed prospectively in participants in opportunistic and workplace health check-ups; however, there are no reports of population-based cohort study.
To clarify the population-based risk of Helicobacter pylori infection and atrophic gastritis for gastric cancer, a cohort study was conducted in rural towns in Kyoto Prefecture.
Subjects were 1,011 males and 1,848 females recruited in a health check-up in 1987. Their serum was examined for anti-Helicobacter pylori antibodies and pepsinogen I and II. Gastric cancer cases were assessed from the cancer registry of those towns.
Up to the end of 1996, 33 males and 28 females developed gastric cancer. A sex- and age-adjusted hazard ratio was calculated by Cox’s proportional model. Helicobacter pylori infection increased the risk of gastric cancer even when the subjects had no atrophy (hazard ratio = 4.20; 95% confidence interval, 0.96–18.40). The risk increased further when they had both Helicobacter pylori infection and atrophy (hazard ratio = 11.23; 95% confidence interval, 2.71–46.51). Subjects with atrophy but negative for anti-Helicobacter pylori antibodies had the highest risk (hazard ratio = 14.81; 95% confidence interval, 2.47–88.80).
A high-risk group for gastric cancer can be selected by serological prescreening.
- The Editorial Board of the Cancer Statistics in Japan. Cancer Statistics in Japan 2008. Tokyo, Foundation for Promotion Cancer Research; 2008.
- Oshima A, Hirata N, Ubukata T, Umeda K, Fujimoto I. Evaluation of a mass screening program for stomach cancer with a case-control study design. Int J Cancer. 1986;38:829–833. CrossRef
- Fukao A, Tsubono Y, Tsuji I, Hisamichi S, Sugahara N, Takano A. The evaluation of screening for gastric cancer in Miyagi Prefecture, Japan: a population-based case-control study. Int J Cancer. 1995;60:45–48. CrossRef
- Walker IR, Strickland RG, Ungar B, Mackay IR. Simple atrophic gastritis and gastric carcinoma. Gut. 1971;12:906–911. CrossRef
- Sipponen P, Kekki M, Haapakoski J, Ihamaki T, Siurala M. Gastric cancer risk in chronic gastritis: statistical calculations of cross-sectional data. Int J Cancer. 1985;35:173–177. CrossRef
- Correa P. Human gastric carcinogenesis: a multi-step and multifactorial process, first American cancer society award lecture on cancer epidemiology and prevention. Cancer Res. 1992;52:6735–6740.
- Tatsuta M, Iishi H, Nakaizumi A, et al. Fundal atrophic gastritis as a risk factor for gastric cancer. Int J Cancer. 1993;53:70–74. CrossRef
- Parsonnet J, Friedman GD, Vandersteen DP, et al. Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med. 1991;325:1127–1131. CrossRef
- Nomura A, Stemmermann GN, Chyou PH, Kato I, Perez-Perez GI, Blaser MJ. Helicobacter pylori infection and gastric carcinoma among Japanese American in Hawaii. N Engl J Med. 1991;325:1132–1136. CrossRef
- Forman D, Newell DG, Fullerton F, et al. Association between infection with Helicobacter pylori and risk of gastric cancer: Evidence from a prospective investigation. BMJ. 1991;302:1302–1305. CrossRef
- Parsonnet J, Samloff IM, Nelson LM, Orentreich N, Vogelman JH, Friedman GD. Helicobacter pylori, pepsinogen, and risk for gastric adenocarcinoma. Cancer Epidemiol Biomarkers Prev. 1993;2:461–466.
- Watanabe Y, Kurata JH, Mizuno S, et al. Helicobacter pylori infection and gastric cancer: a nested case-control study in a rural area of Japan. Dig Dis Sci. 1997;42:1383–1387. CrossRef
- Ozasa K, Kurata JH, Higashi A, et al. Helicobacter pylori infection and atrophic gastritis, a nested case-control study in a rural town in Japan. Dig Dis Sci. 1999;44:253–256. CrossRef
- Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–789. CrossRef
- Uemura N, Mukai T, Okamoto S, et al. Effect of Helicobacter pylori eradication on subsequent development of cancer after endoscopic resection of early gastric cancer. Cancer Epidemiol Biomarkers Prev. 1997;6:639–642.
- You WC, Brown LM, Zhang L, et al. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst. 2006;98:974–983. CrossRef
- Fukase K, Kato M, Kikuchi 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;372:392–397. CrossRef
- Watabe H, Mitsushima T, Yamaji Y, et al. Predicting the development of gastric cancer from combining Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study. Gut. 2005;54:764–768. CrossRef
- Ohata H, Kitauchi S, Yoshimura N, et al. Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer. Int J Cancer. 2004;109:138–143. CrossRef
- Kudo M, Kato M, Meguro T, Kimura S, Asaka M, Miyazaki T. Measurement of antibody to Helicobacter pylori by enzyme immunoassay. Shinyaku to Rinsho. 1993;42:2581–2584. (Japanese).
- Miki K, Ichinose M, Yahagi N. The clinical application of the serum pepsinogen I and II levels as mass screening method for gastric cancer. In: Takahashi K, et al., eds. Aspartic Proteinase: Structure, Function, Biology and Biomedical Implications. New York: Plenum; 1995:139–143.
- Miki K, Ichinose M, Shimizu A, et al. Serum pepsinogens as a screening test of extensive chronic gastritis. Gastroenterol Jpn. 1987;22:133–141.
- Ichinose M, Miki K, Furihata C. Radioimmunoassay of serum group I and group II pepsinogens in normal controls and patients with various disorders. Clin Chim Acta. 1982;126:183–191. CrossRef
- Hamashima C, Shibuya D, Yamazaki H, et al. The Japanese guidelines for gastric cancer screening. Jpn J Clin Oncol. 2008;38:259–267. CrossRef
- Miles A, Cockburn J, Smith RA, Wardle J. A perspective from countries using organized screening programs. Cancer. 2004;101:1201–1213. CrossRef
- Statistics and Information Department, Ministry of Health, Labour, and Welfare. National Reports on Cancer Screening Programs 2004. Tokyo, Health and Welfare Statistics Association; 2006.
- Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1:1311–1315. CrossRef
- Infection with Helicobacter pylori. In: IARC Monographs on the Evaluation of the Carcinogenic Risks to Humans. Vol. 61. Schistosomes, liver flukes and Helicobacter pylori. Lyon, International Agency for Research on Cancer; 1994:177–241.
- Thompson Coon J, Rogers G, Hewson P, et al. Surveillance of cirrhosis for hepatocellular carcinoma: a cost-utility analysis. Br J Cancer. 2008;98:1166–1175. CrossRef
- Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis
Digestive Diseases and Sciences
Volume 55, Issue 11 , pp 3132-3137
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Cohort study
- Gastric cancer
- Mass screening
- Helicobacter pylori
- Atrophic gastritis
- Industry Sectors
- Author Affiliations
- 1. Department of Medical Pharmaceutics, Kobe Pharmaceutical University, 4-19-1 Motoyama-kita, Higashinada-ku, Kobe, 658-8558, Japan
- 2. Division of Gastroenterology, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
- 3. Department of Gastroenterology, Saiseikai Noe Hospital, 2-2-33 Imahuku-higashi, Joto-ku, Osaka, 536-0002, Japan
- 4. Department of Gastroenterology, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan
- 5. Department of Epidemiology, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan
- 6. Japan Research Foundation of Prediction, Diagnosis and Therapy for Gastric Cancer (JRF PDT GC), 1-17-2-604 Shirogane, Minato-ku, Tokyo, 108-0072, Japan
- 7. Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan