| [ Summary ] |
Problems with serum Helicobacter pylori (H. pylori) antibody tests for the evaluation of gastric cancer risk are discussed. The diagnostic ability of serum H. pylori antibody tests depends on cutoff values. Cutoff values should be lowered for first time screenings of subjects at risk of gastric cancer. However, even if the cutoff values are lowered, those who have a history of previous H. pylori infection cannot be absolutely determined because antibody titers gradually decline from positive into negative ranges after infections are cured. To determine subjects with present or past infection, which are both at risk of gastric cancer, from the subjects with negative-H. pylori antibody tests, image based diagnoses such as barium X-rays or endoscopic examinations should be conducted because present or past H. pylori infections can be discerned. Therefore, it is recommended those image based tests be conducted at least once before exclusion of subjects with negative-H. pylori antibody test from the subjects who need regular gastric cancer surveillance. |