title: Recent development of gastric cancer prevention.
abstract: A mass screening program using photofluorography has been used as a secondary prophylaxis of gastric cancer in Japan. However, we are at a turning point for reconsidering the strategy of gastric cancer prevention because of various problems with photofluorography. The shift from current secondary prophylaxis to primary prophylaxis is now required. After a Japanese multicenter randomized controlled trial showed that Helicobacter pylori eradication reduced the incidence of metachronous gastric cancer after endoscopic resection of early gastric cancer, primary prophylaxis of gastric cancer has gained greater attention. The combination of H. pylori eradication as a primary prophylaxis and screening as a secondary prophylaxis is necessary for the elimination of gastric cancer in Japan. The strategy of test, treat and screening for H. pylori infection is effective in reducing the incidence and mortality of gastric cancer in communities with a high incidence of gastric cancer. We have proposed a program of risk stratification based on the presence of H. pylori infection with or without atrophic gastritis followed by targeted interventions.
authors.affiliation: Division of Endoscopy, Hokkaido University Hospital, Department of Cancer Preventive Medicine, Hokkaido University Graduate School of Medicine, North 14, West 5, Kita-ku, Sapporo, Hokkaido 060-8468, Japan. m-kato@med.hokudai.ac.jp
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Kato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asaka
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000382:microbiology / Q000517:prevention & control*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000639:trends; D013274:Stomach Neoplasms / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents