| Theme |
Best Available Managements of Helicobacter pylori Gastritis |
| Title |
Risk of Gastric Cancer after Helicobacter pylori Eradication |
| Author |
Takeichi Yoshida |
Department of Gastroenterology, Wakayama Medical University |
| Author |
Takao Maekita |
Department of Gastroenterology, Wakayama Medical University |
| Author |
Shotaro Enomoto |
Wakayama Wellness Foundation |
| Author |
Mika Watanabe |
Wakayama Wellness Foundation |
| Author |
Jun Kato |
Department of Gastroenterology, Wakayama Medical University |
| Author |
Masao Ichinose |
Department of Gastroenterology, Wakayama Medical University |
| [ Summary ] |
Our studies indicate that the annual incidence rate of gastric cancer is 0.24 % in the subjects with chronic atrophic gastritis (CAG) assessed by serum pepsinogens (PGs) and is 0.11 % in those without CAG among Helicobacter pylori-infected healthy subjects in Japan. In addition, a concrete risk of gastric cancer is revealed with serum levels of PG I, PG II, and PG I/PG II ratio, respectively. Randomized controlled trials (RCTs) suggested that H. pylori eradication might marginally reduce gastric cancer incidence in the general population and that the annual incidence rate of gastric cancer is 0.07-0.36 % in H. pylori eradicated groups. Observational studies from Japan showed that the mean annual incidence rate of gastric cancer is 0.23 % (0.11-0.46 %) in H. pylori eradicated patients, implying the necessity of follow-ups for these patients. Recently, we demonstrated that H. pylori eradication significantly reduced the annual incidence rate of gastric cancer only in the healthy subjects without CAG assessed by serum PGs, suggesting that CAG identified by serum PGs is beyond the point of no return during gastric carcinogenesis. Assessment of CAG with serum PGs provides indices of both the future risk of gastric cancer and the effects of H. pylori eradication on cancer control. |