Abstract
In 2010, the Kobe Steel Corporation Group introduced a new gastric cancer screening test combining the ABC health check and endoscopic test to the periodical health check of its employees and started eradication of Helicobacter pylori as a treatment based on gastroendoscopic findings. We have been checking serum pepsinogen (PG) for 2 consecutive years. Of 16,837 cases screened, 1.1% of PG negative subjects became PG positive while 6.8% of PG positive subjects became PG negative. The remaining 92.1% of subjects showed unchanged PG status. Eradication of Helicobacter pylori was performed for 32.0% of the subjects whose PG value became positive and for 80.7% of the subjects whose PG value became negative. Excluding the effect of eradication of Helicobacter pylori, subjects whose PG value became positive were 0.7% and subjects whose PG value turned negative were 1.3%. With cases of a discrepancy between the risk classification and gastroendoscopic findings and with cases of PG pseudopositive or PG pseudonegative, it is crucial to incorporate gastroendoscopic findings for screening. PG values are helpful for judging eradication but it is difficult to evaluate the degree of gastric atrophy solely by the PG value for successful eradication cases of Helicobacter pylori, since PG values become negative at the early stage of successful pylori eradication cases.
