Abstract
The ABC classification system is used for assessing gastric cancer risk during screening, based on a combination of serum Helicobacter pylori (Hp) antibody and pepsinogen (PG) levels. This study aims to clarify the usefulness of the ABC classification system in assessing gastric cancer risk during medical checkups. The study included 1,223 individuals (mean age, 56.3 years) who underwent medical checkups at our hospital. Their risk of gastric cancer was assessed using the ABC classification system. Group A included 61% of participants, with the proportion of individuals classified as being in group A decreasing with age. Gastric cancer was detected by endoscopy on the same day in four patients (three patients in group C and one patient in group A), all above 65 years old with progressive gastric mucosal atrophy. Further, gastric mucosal atrophy was endoscopically detected in 13.9% of group A cases (“pseudo A” group). The proportion of patients over 60 years old and of those with Hp antibody values of more than 3.0 were significantly higher in the “pseudo A” group than in the “true A” group comprising patients with no gastric mucosal atrophy. Progressive gastric mucosal atrophy was noted in 20 patients in the “pseudo A” group, whose PG I values were low and/or whose Hp antibody values were more than 3.0, indicating current or prior Hp infection. Our results indicate that, for accurate gastric cancer risk assessment, the ABC classification system should be used in conjunction with endoscopy, especially at the first screening.
