| [ Summary ] |
ABC classification in combination with serum Helicobacter pylori (Hp) antibody and PG evaluation is a useful tool for stratification of predictive risk for gastric cancer development. Introduction into a population‒based screening program is expected to produce favorable results, by 1) making mass screening for gastric cancer efficient by targeting high‒risk subjects, 2) reducing unnecessary examinations for low‒risk subjects, 3) increasing the number of examinations for those who have never undergone screening, and 4) leading to eradication therapy for patients infected with Hp as a possible protective measure against gastric cancer development. However, this methodology has some serious drawbacks : 1) uncertain diagnostic accuracy for securely excluding low‒risk subjects from the screening program, 2) lack of long term monitoring of high‒risk subjects who need repeated, detailed examination, 3) undefined gastric cancer risk after successful Hp eradication, and 4) the lack of measures against post‒eradication cancer development. The efficacy of a risk‒based screening program for gastric cancer has not been scientifically verified, and the adoption of such a population‒based screening program is considered inappropriate. |