Future aspects of gastric cancer screening will become to perform gastric cancer –risk screening using the following method: Subjects are classified into a 1 of 4 groups (A to D) based on the results of the 2 serologic tests, anti-Helicobacter pylori (Hp) IgG antibody titer and the pepsinogen(PG) I and II levels (PG Method); Group A [Hp(–)·PG(–)], infection free or mild subjects; Group B [Hp(+)·PG(–)], chronic atrophic gastritis free; Group C [Hp(+)·PG(+)], chronic atrophic gastritis, and Group D [Hp(–)·PG(+)]), severe chronic atrophic gastritis with extensive intestinal metaplasia, respectively. Thereafter, continuous endoscopic follow-up examination should be performed to detect early stage of gastric cancer. Asymptomatic Group A which is occupied 50–80% of all subjects may be excluded from the secondary endoscopic examination for the efficiency of gastric cancer screening system. Hp infected subjects (H. pylori infectious disease); Group B and C should be eradicated aiming to prevent occurrence of gastric cancer (the primary prevention of gastric cancer), as well as the secondary prevention of gastric cancer.

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[in Japanese]

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