Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis
- First Online:
- 330 Downloads
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.
KeywordsCohort study Gastric cancer Mass screening Helicobacter pylori Atrophic gastritis
- 1.The Editorial Board of the Cancer Statistics in Japan. Cancer Statistics in Japan 2008. Tokyo, Foundation for Promotion Cancer Research; 2008.Google Scholar
- 20.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).Google Scholar
- 21.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.Google Scholar
- 26.Statistics and Information Department, Ministry of Health, Labour, and Welfare. National Reports on Cancer Screening Programs 2004. Tokyo, Health and Welfare Statistics Association; 2006.Google Scholar
- 28.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.Google Scholar