Clinical Gastroenterology Vol.28 No.8(6)

Theme Determination of Gastric Cancer Risk -- Current Conditions and Issues
Title ABC Method and Gastric Cancer Screening in Rural Japanese Areas (Yubari City, Fukushima Town and Yamagata City)
Publish Date 2013/07
Author Katsuhiro Mabe Division of Endoscopy, Hokkaido University Hospital
Author Seiichi Furuta Division of Pharmaceutical Community Health Care, Faculty of Social Pharmacy, Hokkaido Pharmaceutical University, School of Pharmacy
Author Minoru Ogasawara Internal Medicine, Ogasawara Medical Clinic
Author Haruhumi Oizumi Internal Medicine, Oizumi Medical Clinic
Author Shogo Kikuchi Department of Public Health, Aichi Medical University, School of Medicine
Author Mototsugu Kato Division of Endoscopy, Hokkaido University Hospital
[ Summary ] H. pylori (Hp) is a definite carcinogen related to gastric cancer. It is possible to prevent this disease by eradicating Hp. In Japan, gastric cancer screening has been conducted using barium X-ray examinations to detect cancer. However, since it is now well established that Hp infection causes gastric cancer, we should consider better screening methods to detect the carcinogen rather than the disease. To investigate applicability for mass screening, we used the ABC method, a combination of detection of serum anti-Hp antibodies and measurement of the level of serum pepsinogens (PG). These tests were conducted in three Japanese areas with relatively high-standardized mortality rates (SMR) for gastric cancer. The results showed that about half of the residents were classified into group A [Hp (-) PG (-)]. They were considered to be infection-free subjects who could be excluded from gastric cancer screening. On the other hand, it was also demonstrated that Hp infection rates differed by area and age. There are several problems involved with adopting this method for screening of different populations as well as developing strategies for surveillance and preventive therapy with limited resources.
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