Clinical Gastroenterology Vol.28 No.8(3)

Theme Determination of Gastric Cancer Risk -- Current Conditions and Issues
Title Judgment of Gastric Cancer Risk and Introduction of Gastric Cancer Screening
Publish Date 2013/07
Author Kazuhiko Inoue Department of General Medicine, Kawasaki Medical School
[ Summary ] Infection with Helicobacter pylori (Hp) is considered a prerequisite for gastric carcinogenesis, as is gastric mucosal atrophy which develops in association with the infection and is a risk factor for gastric cancer. The risk of gastric cancer can be assessed by using the ABC classification method. This method consists of a combination of techniques for measuring serum Hp antibodies and using the pepsinogen (PG) method, determining those in Group C with the PG method. A positive indication is considered to indicate those in the high risk group for gastric cancer, Group A subjects with Hp antibodies (-) and those assessed with the PG method (-) are in the low risk group. ABC classification is expected to greatly contribute to population-based screening. However, it should be noted that inappropriate categorization of cases with a past history of Hp infection and those with persistent infection into Group A must be avoided. In addition, patients with high PG II levels in Group B, exhibiting Hp antibodies (+) and those analyzed with the PG method (-), are considered to be in a group which is at high risk of gastric cancer. Therefore, standardization is desirable. Furthermore, it should not be forgotten that gastric cancer cannot be diagnosed solely through use of ABC classification and a combination of imaging examinations is necessary. It is also necessary to reinforce our control systems for ongoing yearly medical checkups for gastric cancer.
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