| Theme |
Gastric Cancer Screening -- Present Status and Uprising High-risk Strategy |
| Title |
The Two Serum Tests Allow Evaluation of Gastric Cancer Risk in Each Subject and Identification of Individuals at High Risk for the Cancer |
| Author |
Kimihiko Yanaoka |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Chizu Mukoubayashi |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Hisanobu Deguchi |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Takao Maekita |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Hirohito Magari |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Mikitaka Iguchi |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Hideyuki Tamai |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Kenji Arii |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Masashi Oka |
Second Department of Internal Medicine, Wakayama Medical University |
| Author |
Masao Ichinose |
Second Department of Internal Medicine, Wakayama Medical University |
| [ Summary ] |
In high risk areas such as Japan, the main course of stomach carcinogenesis is considered to begin with gastritis, proceeding to extensive atrophy with intestinal metaplasia, then on to dysplasia, and finally to cancer. However, there is controversy as to whether the risk of gastric cancer increases with the progression of atrophy and intestinal metaplasia, which results from gastritis, or whether high levels of gastritis pose a high risk. In order to clarify this point, a longitudinal cohort study over a ten-year period was conducted. The subjects consisted of 5,209 asymptomatic male employees, 40 to 59 years old (average age 49.5 ± 4.6), who underwent an annual multiphasic health checkup in their workplace in Wakayama City, Japan. The subjects were screened annually to identify incident gastric cancer over a 10-year period between 1994 and 2004. Atrophic gastritis was evaluated through endoscopic diagnosis, serum pepsinogen testing and Helicobacter pylori titer measurement. The subjects were divided into four groups labeled A through D [A Group HP (-) PG (-), B Group : HP (+) PG (-), C Group : HP (+) PG (+), D Group : HP (-) PG (+), with the degree of atrophic gastritis being greater sequentially from group A to D, with group D being equivalent to metaplastic gastritis]. In relation to the stage of HP-associated gastritis, 25 cases were in group B, 30 cases in group C, 4 cases in group D. No cancer developed in group A. Thus, the annual incidence of gastric cancer in each group was null in group A, 0.1 % in group B, 0.24 % in group C. and 1.3 % in group D. No gastric cancer developed is HP-free and CAG-free healthy stomachs, while the risk of the cancer increased in a progressive fashion with the progression of HP-associated gastritis. |