2019 Volume 57 Issue 4 Pages 561-570
With an aim of accelerating the endoscopic screening and eradication therapy for Helicobacter pylori (H. pylori)infection, Hoki-cho in Tottori Prefecture has implemented a risk evaluation system for gastric cancer using serum containing H. pylori antibody for five years since the fiscal year 2014. Target populations included subjects aged 20 and 35-70 years in each year and who underwent at least one examination through the evaluation system during this period. In cases with a negative result for H. pylori diagnosis, we incorporated the serum pepsinogen method. During the three years from the 2014-2016 fiscal year, there were a total of 5866 target individuals, of whom 1988 received this screening (participation rate: 33.9%). This rate was high in females and in subjects aged 60-70 years and low in those aged 35-59 years. The total number of cases positive for H. pylori antibody was 657 (33.0%). The frequency of H. pylori positivity was 8.0% in subjects aged 20 years, <40% in subjects aged 60-70 years, and gradually increased with advancing age. Consequently, during the 3-year study period, 72.8% of examinees underwent a detailed endoscopic examination, and two patients with early gastric cancer were detected. Eradication therapy was implemented in 97.2% of cases undergoing a detailed endoscopic examination with a positive result for H. pylori infection. On the other hand, 28.8% of individuals with positive screening results in the fiscal year 2014 had received periodical endoscopic screening at least once during the three years after the following year. Therefore, it is important to increase the participation rate of this project and the rate of close examinations and to further lead the individual with gastric cancer risk and requiring examination to the periodical endoscopic screening.
