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

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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.

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Acknowledgments

This work was partially supported by a Grant-in-Aid for Scientific Research (B) (No. 06454543), the Ministry of Education, Science, Sports and Culture of Japan, and a Grant-in-Aid for Medical Frontier Strategy Research from the Ministry of Health, Labor, and Welfare, Japan (H13-9).

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Authors and Affiliations

  1. Department of Medical Pharmaceutics, Kobe Pharmaceutical University, 4-19-1 Motoyama-kita, Higashinada-ku, Kobe, 658-8558, Japan

    Shigeto Mizuno, Ikuya Miki & Tsukasa Ishida

  2. Division of Gastroenterology, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Masaru Yoshida, Mitsuko Onoyama & Takeshi Azuma

  3. Department of Gastroenterology, Saiseikai Noe Hospital, 2-2-33 Imahuku-higashi, Joto-ku, Osaka, 536-0002, Japan

    Yasuki Habu

  4. Department of Gastroenterology, Hyogo Cancer Center, 13-70 Kitaouji-cho, Akashi, 673-8558, Japan

    Hideto Inokuchi

  5. Department of Epidemiology, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima, 732-0815, Japan

    Kotaro Ozasa

  6. Japan Research Foundation of Prediction, Diagnosis and Therapy for Gastric Cancer (JRF PDT GC), 1-17-2-604 Shirogane, Minato-ku, Tokyo, 108-0072, Japan

    Kazumasa Miki

  7. Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Yoshiyuki Watanabe

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  1. Shigeto Mizuno
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  2. Ikuya Miki
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  10. Kazumasa Miki
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Correspondence to Yoshiyuki Watanabe.

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Mizuno, S., Miki, I., Ishida, T. et al. Prescreening of a High-Risk Group for Gastric Cancer by Serologically Determined Helicobacter pylori Infection and Atrophic Gastritis. Dig Dis Sci 55, 3132–3137 (2010). https://doi.org/10.1007/s10620-010-1154-0

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  • DOI: https://doi.org/10.1007/s10620-010-1154-0

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