nach oben

Erschienen in:

01.11.2010 | Original Article

Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis

verfasst von: Shigeto Mizuno, Ikuya Miki, Tsukasa Ishida, Masaru Yoshida, Mitsuko Onoyama, Takeshi Azuma, Yasuki Habu, Hideto Inokuchi, Kotaro Ozasa, Kazumasa Miki, Yoshiyuki Watanabe

Erschienen in: Digestive Diseases and Sciences | Ausgabe 11/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

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.

Aims

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.

Methods

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.

Results

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).

Conclusions

A high-risk group for gastric cancer can be selected by serological prescreening.

The Editorial Board of the Cancer Statistics in Japan. Cancer Statistics in Japan 2008. Tokyo, Foundation for Promotion Cancer Research; 2008.

Oshima A, Hirata N, Ubukata T, Umeda K, Fujimoto I. Evaluation of a mass screening program for stomach cancer with a case-control study design. Int J Cancer. 1986;38:829–833.CrossRefPubMed

Fukao A, Tsubono Y, Tsuji I, Hisamichi S, Sugahara N, Takano A. The evaluation of screening for gastric cancer in Miyagi Prefecture, Japan: a population-based case-control study. Int J Cancer. 1995;60:45–48.CrossRefPubMed

Walker IR, Strickland RG, Ungar B, Mackay IR. Simple atrophic gastritis and gastric carcinoma. Gut. 1971;12:906–911.CrossRefPubMed

Sipponen P, Kekki M, Haapakoski J, Ihamaki T, Siurala M. Gastric cancer risk in chronic gastritis: statistical calculations of cross-sectional data. Int J Cancer. 1985;35:173–177.CrossRefPubMed

Correa P. Human gastric carcinogenesis: a multi-step and multifactorial process, first American cancer society award lecture on cancer epidemiology and prevention. Cancer Res. 1992;52:6735–6740.PubMed

Tatsuta M, Iishi H, Nakaizumi A, et al. Fundal atrophic gastritis as a risk factor for gastric cancer. Int J Cancer. 1993;53:70–74.CrossRefPubMed

Parsonnet J, Friedman GD, Vandersteen DP, et al. Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med. 1991;325:1127–1131.CrossRefPubMed

Nomura A, Stemmermann GN, Chyou PH, Kato I, Perez-Perez GI, Blaser MJ. Helicobacter pylori infection and gastric carcinoma among Japanese American in Hawaii. N Engl J Med. 1991;325:1132–1136.CrossRefPubMed

10.

Forman D, Newell DG, Fullerton F, et al. Association between infection with Helicobacter pylori and risk of gastric cancer: Evidence from a prospective investigation. BMJ. 1991;302:1302–1305.CrossRefPubMed

11.

Parsonnet J, Samloff IM, Nelson LM, Orentreich N, Vogelman JH, Friedman GD. Helicobacter pylori, pepsinogen, and risk for gastric adenocarcinoma. Cancer Epidemiol Biomarkers Prev. 1993;2:461–466.PubMed

12.

Watanabe Y, Kurata JH, Mizuno S, et al. Helicobacter pylori infection and gastric cancer: a nested case-control study in a rural area of Japan. Dig Dis Sci. 1997;42:1383–1387.CrossRefPubMed

13.

Ozasa K, Kurata JH, Higashi A, et al. Helicobacter pylori infection and atrophic gastritis, a nested case-control study in a rural town in Japan. Dig Dis Sci. 1999;44:253–256.CrossRefPubMed

14.

Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–789.CrossRefPubMed

15.

Uemura N, Mukai T, Okamoto S, et al. Effect of Helicobacter pylori eradication on subsequent development of cancer after endoscopic resection of early gastric cancer. Cancer Epidemiol Biomarkers Prev. 1997;6:639–642.PubMed

16.

You WC, Brown LM, Zhang L, et al. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst. 2006;98:974–983.CrossRefPubMed

17.

Fukase K, Kato M, Kikuchi S, et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial. Lancet. 2008;372:392–397.CrossRefPubMed

18.

Watabe H, Mitsushima T, Yamaji Y, et al. Predicting the development of gastric cancer from combining Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study. Gut. 2005;54:764–768.CrossRefPubMed

19.

Ohata H, Kitauchi S, Yoshimura N, et al. Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer. Int J Cancer. 2004;109:138–143.CrossRefPubMed

20.

Kudo M, Kato M, Meguro T, Kimura S, Asaka M, Miyazaki T. Measurement of antibody to Helicobacter pylori by enzyme immunoassay. Shinyaku to Rinsho. 1993;42:2581–2584. (Japanese).

21.

Miki K, Ichinose M, Yahagi N. The clinical application of the serum pepsinogen I and II levels as mass screening method for gastric cancer. In: Takahashi K, et al., eds. Aspartic Proteinase: Structure, Function, Biology and Biomedical Implications. New York: Plenum; 1995:139–143.

22.

Miki K, Ichinose M, Shimizu A, et al. Serum pepsinogens as a screening test of extensive chronic gastritis. Gastroenterol Jpn. 1987;22:133–141.PubMed

23.

Ichinose M, Miki K, Furihata C. Radioimmunoassay of serum group I and group II pepsinogens in normal controls and patients with various disorders. Clin Chim Acta. 1982;126:183–191.CrossRefPubMed

24.

Hamashima C, Shibuya D, Yamazaki H, et al. The Japanese guidelines for gastric cancer screening. Jpn J Clin Oncol. 2008;38:259–267.CrossRefPubMed

25.

Miles A, Cockburn J, Smith RA, Wardle J. A perspective from countries using organized screening programs. Cancer. 2004;101:1201–1213.CrossRefPubMed

26.

Statistics and Information Department, Ministry of Health, Labour, and Welfare. National Reports on Cancer Screening Programs 2004. Tokyo, Health and Welfare Statistics Association; 2006.

27.

Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1:1311–1315.CrossRefPubMed

28.

Infection with Helicobacter pylori. In: IARC Monographs on the Evaluation of the Carcinogenic Risks to Humans. Vol. 61. Schistosomes, liver flukes and Helicobacter pylori. Lyon, International Agency for Research on Cancer; 1994:177–241.

29.

Thompson Coon J, Rogers G, Hewson P, et al. Surveillance of cirrhosis for hepatocellular carcinoma: a cost-utility analysis. Br J Cancer. 2008;98:1166–1175.CrossRefPubMed

Titel: Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis
verfasst von: Shigeto Mizuno
Ikuya Miki
Tsukasa Ishida
Masaru Yoshida
Mitsuko Onoyama
Takeshi Azuma
Yasuki Habu
Hideto Inokuchi
Kotaro Ozasa
Kazumasa Miki
Yoshiyuki Watanabe
Publikationsdatum: 01.11.2010
Verlag: Springer US
Erschienen in: Digestive Diseases and Sciences / Ausgabe 11/2010
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-010-1154-0

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis