Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population

Abstract

ObjeCtiveTo accurately measure the incidence of gastric cancer among patients with gastric precancerous lesions, and to quantify the excess incidence in comparison with people with normal mucosa on endoscopy and a general population. DesignPopulation based cohort study.

Pepsinogen Test for the Evaluation of Precancerous Changes in Gastric Mucosa: a Population-Based Study

“…Moreover, the prevalence of H. pylori increases with age [6,14,25,43]. Our results also showed a further decrease of PG I at the follow-up in groups with already decreased PG I level at baseline, mostly in age groups > 70 years, thus signaling the continuous progression of mucosal changes.…”

“…However, the first specific recognizable step in the precancerous process is GA, defined as the loss of normal glandular tissue [3,5]. In addition, GA is the endpoint of chronic processes, such as chronic gastritis associated with Helicobacter pylori (H. pylori) infection, autoimmunity directed against gastric glandular cells and influence of some other environmental factors [3,5,6]. Although in most developed countries H. pylori now infects less than 20% of adults and 5% of children [7], it has been estimated that GA may still develop in 40-50% of H. pylori-infected individuals, while 1-2% of infected individuals will develop GC during their lifetime [8].…”

“…27 No 1: [11][12][13][14][15][16][17] At present, the gold standard for diagnosis of gastric mucosal changes is the biopsy performed during an upper gastrointestinal endoscopy followed by histological examination [3,6]. Evaluation of the histological status of the mucosa can be performed using the updated Sydney System, the Operative Link on Gastritis Assessment (OLGA) and the Operative Link for Gastric Intestinal Metaplasia assessment (OLGIM) systems.…”

Impact of Cyclooxygenase-2 1195 G-Carrier Genotype Associated with Intestinal Metaplasia and Endoscopic Findings Based on Kyoto Classification

“…Mc Carthy et al [34] have also reported that COX-2 expression in the gastric antrum was reduced by H. pylori eradication therapy. Intestinal metaplasia including dysplasia is widely recognized as a common route to the intestinal type of non-cardia gastric cancer, and Song et al [35] have recently reported that 1 in 39 patients with intestinal metaplasia will develop gastric cancer within 20 years. Kyoto Global Consensus documents provided that the extent of intestinal metaplasia was also associated with the risk of development of gastric cancer in H. pylori gastritis [17].…”

Current approaches to gastric cancer in Peru and Mexico

“…In order to reduce this impact and to improve the outcomes in gastric cancer patients, some necessary steps had been proposed including establishing an improved sanitation system and ensuring access to potable water, which will reduce the infection of Helicobacter pylori of drinking water and ultimately will reduce the incidence of gastric cancer (18). Additional steps to take in Mexico, includes the implementation of a screening system in highrisk population in order to detect early gastric cancer cases, the improvement in the surgical management of gastric cancer cases according with the Japanese guidelines, and the establishment of a multimodality approach to gastric cancer treatment that involves participation of a variety of experts incorporating gastroenterologists, gastric surgeons, oncologists, radiation oncologists and others (19).…”