Identification of patients who are at risk of gastric cancer due to Helicobacter pylori gastritis using barium X-ray in Okayama Prefecture

Abstract

Since 2011, the Okayama Health Foundation has been attempting to identify patients who are at risk of gastric cancer by classifying the background gastric mucosa to detect gastritis due to H. pylori infection by X-ray findings using barium X-rays. Gastric barium X-rays of 15,323 people who underwent local gastric cancer screening in 2011 were obtained; their background gastric mucosae were classified into three groups by X-ray findings: normal (N), atrophic gastritis (AG), and rugal hyperplastic gastritis (HG). Of the patients screened, 70.3% were classified in the N group, 28.0% in the AG group, and 1.7% in the HG group. The detection rate of gastric cancer was 0% in the N group, 0.42% in the AG group, and 1.98% in the HG group; detection rates were significantly higher in the AG and HG groups compared to the N group (P<0.01). The positive predictive values were also high in the AG and HG groups, at 5.5% and 3.9%, respectively. We conclude that the identification of patients who are at risk of gastric cancer from H. pylori infection by X-ray findings using barium X-rays for population-based gastric cancer screening can result in improved detection of gastric cancer.