Digestive Diseases and Sciences

, Volume 55, Issue 11, pp 3132–3137

Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis

Authors

  • Shigeto Mizuno
    • Department of Medical PharmaceuticsKobe Pharmaceutical University
  • Ikuya Miki
    • Department of Medical PharmaceuticsKobe Pharmaceutical University
  • Tsukasa Ishida
    • Department of Medical PharmaceuticsKobe Pharmaceutical University
  • Masaru Yoshida
    • Division of Gastroenterology, Graduate School of MedicineKobe University
  • Mitsuko Onoyama
    • Division of Gastroenterology, Graduate School of MedicineKobe University
  • Takeshi Azuma
    • Division of Gastroenterology, Graduate School of MedicineKobe University
  • Yasuki Habu
    • Department of GastroenterologySaiseikai Noe Hospital
  • Hideto Inokuchi
    • Department of GastroenterologyHyogo Cancer Center
  • Kotaro Ozasa
    • Department of EpidemiologyRadiation Effects Research Foundation
  • Kazumasa Miki
    • Japan Research Foundation of PredictionDiagnosis and Therapy for Gastric Cancer (JRF PDT GC)
    • Department of Epidemiology for Community Health and MedicineKyoto Prefectural University of Medicine Graduate School of Medical Science
Original Article

DOI: 10.1007/s10620-010-1154-0

Cite this article as:
Mizuno, S., Miki, I., Ishida, T. et al. Dig Dis Sci (2010) 55: 3132. doi:10.1007/s10620-010-1154-0

Abstract

Background

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.

Aims

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.

Methods

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.

Results

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).

Conclusions

A high-risk group for gastric cancer can be selected by serological prescreening.

Keywords

Cohort study Gastric cancer Mass screening Helicobacter pylori Atrophic gastritis

Copyright information

© Springer Science+Business Media, LLC 2010