Abstract
We established a system for gastric cancer risk screening (ABC classification) in Matsumoto city by referring to the results of the ABC classification used in individuals who had undergone upper gastrointestinal endoscopy using a new Helicobacter pylori (Hp) antibody reagent, SphereLight H. pylori antibody∙J, with higher sensitivity for measuring Hp antibody levels than the currently used reagent. Group B was subdivided into groups B-1 (pepsinogen II <30 ng/mL) and B-2 (pepsinogen II ≥30 ng/mL) to identify group B individuals at high risk for undifferentiated carcinoma. The ABC classification in Matsumoto city consists of 4 groups: group A, B-1, B-2, and C (C and D). Groups A, B-1, and B-2 and C together were defined as low-, middle-, and high-risk groups, respectively. Individuals in group B-1 or higher had to undergo detailed endoscopic examination. Group B-1 subjects were recommended to undergo endoscopy every 2 or 3 years; yearly endoscopic examination was recommended for group B-2 and C subjects. To avoid including high-risk individuals (false A) into group A, pepsinogen (PG) levels (PGI ≤35 ng/mL and PG I/II ≤4.0, PGII ≥15 ng/mL) were used to screen these individuals.
Continuous follow-up after risk screening is important. Matsumoto city introduced a “gastric health” handbook for individuals who had undergone screening to improve their understanding of gastric cancer risk and motivate them to undergo endoscopic examination. We aimed at establishing a system that allows continuous endoscopic follow-up, such as recording, results of check-ups, endoscopic findings, and eradication success and failure can be recorded in the handbook.
A gastric cancer risk screening (ABC classification) was initiated in 2014 using this screening system.
It is important to examine the efficacy and issues of this screening system and to further develop it in cooperation with the local government in the future.
