Diagnosis of gastric cancer risk: Additional criteria to reduce the prevalence of patients in Group pseudo-A

Abstract

With the introduction of risk diagnosis in population-based regional screening for gastric cancer, the following additional criteria were proposed to reduce the prevalence of patients in Group pseudo-A: pepsinogen (PG) I level ≤ 35 ng/mL, PGIIlevel ≥ 15 ng/mL, Helicobacter pylori (HP) antibody titer of 5-10 U/mL, or a history of HP eradication. If examinees assigned to Group A, based on the conventional criteria, meet any of the additional criteria, they are subjected to detailed examination by using endoscopy (detailed Group A examination). In 2013, a total of 17,325 people underwent the screening program. Detailed examination was required in 40.9% (4,052/9,916) of Group A subjects. Of these patients, 45.5% (342/751) had atrophic gastritis and 4 had gastric cancer.
We estimated that Group pseudo-A subjects accounted for 11.1% of the total number of Group A subjects without an HP eradication history. The ratio of subjects with gastric cancer to subjects requiring detailed examination in Group pseudo-A was 1.65%, comparable to the ratio in Group C. The additional criteria were satisfied by most, but not all, Group pseudo-A subjects. Furthermore, the number of examinees requiring detailed examinations in Group A was high, with many pseudo-positive subjects. Therefore, refinements of the additional criteria are being considered.