Digestive Diseases and Sciences

, Volume 55, Issue 11, pp 3132–3137 | Cite as

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

  • Shigeto Mizuno
  • Ikuya Miki
  • Tsukasa Ishida
  • Masaru Yoshida
  • Mitsuko Onoyama
  • Takeshi Azuma
  • Yasuki Habu
  • Hideto Inokuchi
  • Kotaro Ozasa
  • Kazumasa Miki
  • Yoshiyuki WatanabeEmail author
Original Article



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.


Cohort study Gastric cancer Mass screening Helicobacter pylori Atrophic gastritis 



This work was partially supported by a Grant-in-Aid for Scientific Research (B) (No. 06454543), the Ministry of Education, Science, Sports and Culture of Japan, and a Grant-in-Aid for Medical Frontier Strategy Research from the Ministry of Health, Labor, and Welfare, Japan (H13-9).


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Shigeto Mizuno
    • 1
  • Ikuya Miki
    • 1
  • Tsukasa Ishida
    • 1
  • Masaru Yoshida
    • 2
  • Mitsuko Onoyama
    • 2
  • Takeshi Azuma
    • 2
  • Yasuki Habu
    • 3
  • Hideto Inokuchi
    • 4
  • Kotaro Ozasa
    • 5
  • Kazumasa Miki
    • 6
  • Yoshiyuki Watanabe
    • 7
    Email author
  1. 1.Department of Medical PharmaceuticsKobe Pharmaceutical UniversityKobeJapan
  2. 2.Division of Gastroenterology, Graduate School of MedicineKobe UniversityKobeJapan
  3. 3.Department of GastroenterologySaiseikai Noe HospitalOsakaJapan
  4. 4.Department of GastroenterologyHyogo Cancer CenterAkashiJapan
  5. 5.Department of EpidemiologyRadiation Effects Research FoundationHiroshimaJapan
  6. 6.Japan Research Foundation of PredictionDiagnosis and Therapy for Gastric Cancer (JRF PDT GC)TokyoJapan
  7. 7.Department of Epidemiology for Community Health and MedicineKyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan

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