| Theme |
Evidence-based Guidelines Version 2 for Gastric Cancer Screening ; The Beginning of a New Era of Endoscopic Cancer Screening |
| Title |
Gastric Cancer Risk Evaluated with Serum Levels of Pepsinogen and Helicobacter pylori Antibody |
| Author |
Takeichi Yoshida |
Department of Gastroenterology, Wakayama Medical University |
| Author |
Shotaro Enomoto |
NS Medical & Healthcare Service |
| Author |
Mika Watanabe |
NS Medical & Healthcare Service |
| Author |
Hideyuki Tamai |
Department of Gastroenterology, Wakayama Medical University |
| Author |
Jun Kato |
Department of Gastroenterology, Wakayama Medical University |
| Author |
Masao Ichinose |
Department of Gastroenterology, Wakayama Medical University |
| [ Summary ] |
We have recently revealed that both highly active gastritis and severe atrophic gastritis are high risk of gastric cancer in Helicobacter pylor (H. pylori)‒associated gastritis in the follow‒up study of 4,655 healthy asymptomatic subjects, in whom serum pepsinogen (PG) and H. pylori antibody titer had been measured. As supported by several reports, these serum markers would be promising for assessing gastric cancer risk in subjects with H. pylori infection, and are expected to provide a future basis for a more efficient screening program, wherein target settings are based on individual cancer risk. Although a screening method utilizing serum risk markers seems like an ideal framework, its feasibility has to be validated for many crucial points. In particular, this requires much more administrative work than the present method, and the managerial burden might be too great to maintain efficacy. Additionally, the false negative rate of the H. pylori antibody test, which is currently widely used, is high at a non‒negligible level. Until these problems are resolved, incomplete methods, including the so‒called "ABC‒method", should not be adopted for screening. More importantly, to protect the public's health, a reliable and sustainable program for gastric cancer screening should be developed. |