Department of Medical Pharmaceutics, Kobe Pharmaceutical University, 4−19−1 Motoyama−kita, Higashinada−ku, Kobe, 658−8558, Japan, mizuno@kobepharma−u.ac.jp.
Dig Dis Sci. 2010 Mar 4.
Though gastric cancer screening by X−ray examination has been confirmed to be effective for reducing gastric cancer mortality, decreases in efficiency have been pointed out. Establishment of an effective screening system, focusing on high−risk status such as Helicobacter pylori infection and atrophic gastritis, is desirable. To date, combined use of serum anti−Helicobacter pylori antibodies and pepsinogen measurement has been assessed prospectively in participants in opportunistic and workplace health check−ups; however, there are no reports of population−based cohort study.
To clarify the population−based risk of Helicobacter pylori infection and atrophic gastritis for gastric cancer, a cohort study was conducted in rural towns in Kyoto Prefecture.
Subjects were 1,011 males and 1,848 females recruited in a health check−up in 1987. Their serum was examined for anti−Helicobacter pylori antibodies and pepsinogen I and II. Gastric cancer cases were assessed from the cancer registry of those towns.
Up to the end of 1996, 33 males and 28 females developed gastric cancer. A sex− and age−adjusted hazard ratio was calculated by Cox's proportional model. Helicobacter pylori infection increased the risk of gastric cancer even when the subjects had no atrophy (hazard ratio = 4.20; 95% confidence interval, 0.96−18.40). The risk increased further when they had both Helicobacter pylori infection and atrophy (hazard ratio = 11.23; 95% confidence interval, 2.71−46.51). Subjects with atrophy but negative for anti−Helicobacter pylori antibodies had the highest risk (hazard ratio = 14.81; 95% confidence interval, 2.47−88.80).
A high−risk group for gastric cancer can be selected by serological prescreening.
PMID: 20204698 [PubMed − as supplied by publisher] Source: National Library of Medicine.
