| [ Summary ] |
A study was previously conducted on the accuracy of the pepsinogen (PG) method and its effectiveness in reducing mortality rates for stomach cancer. A stomach cancer screening system was developed which is economically feasible for bringing about a reduction in stomach cancer mortality rates. A high risk strategy for stomach cancer screening was adopted. It was used after conducting a comprehensive economic evaluation and is considered to be an effective countermeasure for stomach cancer in relation to previous research findings. These findings are as follows : (1) The effectiveness of reducing stomach cancer mortality rates using the PG method alone was confirmed using an observation technique in the form of a case-control study (retrospectively over the course of 13 years) based on data obtained from areas implementing stomach cancer examinations using the PG method. (2) The accuracy of the PG method was demonstrated to be nearly equal to that of X-rays (digital radiography ; DR). Examinations combining the PG and X-ray metbods were found to be both feasible and useful in a study of the accuracy and cost effectiveness of the PG and X-ray methods by conducting stomach cancer examinations combining the PG method and X-ray method (DR). (3) In a study of the annual incidence of stomach cancer and the hazard ratio for stomach cancer examinations combining assays of Helicobacter pylori (Hp) antibody levels and the PG method (follow-up study on healthy males over a period of 10 years), stomach cancer was observed to not have occurred for 10 years in a group free of Hp infection (Group A : Hp (-). PG (-)), this Group A was designated as a low risk group and excluded from stomach cancer examinations. Stomach cancer examinations consisting of selective screening for groups with atrophic gastritis complications (Groups B, C and D) were demonstrated to be feasible. In the future, it is strongly hoped that the efficiency of stomach cancer examinations will be improved and that stomach cancer examinations which are economical, while also bringing about a reduction in stomach cancer mortality rates, will be implemented by promoting and expanding the number of stomach cancer examinations combining assays of Hp antibody levels. The role of the PG method, as described above, should be expanded on a national scale. In conclusion, the use of assays of Hp antibody levels and the PG method for primary screening, as well as the use of endoscopic examinations (small diameter or transnasal) for secondary screening is considered to be the recommended approach for stomach cancer examinations, providing countermeasures against stomach cancer. |