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Review
. 2014 Jan;49(1):1-8.
doi: 10.1007/s00535-013-0897-8. Epub 2013 Oct 27.

Roadmap to eliminate gastric cancer with Helicobacter pylori eradication and consecutive surveillance in Japan

Masahiro Asaka  1 , Mototsugu Kato, Naoya Sakamoto
Affiliations
Review

Roadmap to eliminate gastric cancer with Helicobacter pylori eradication and consecutive surveillance in Japan

Masahiro Asaka et al. J Gastroenterol. 2014 Jan.

Abstract

In Japan, the annual number of deaths from gastric cancer is approximately 50,000 and there has been no change over the last 50 years. So far, all efforts have been directed toward improving the detection of early gastric cancer by barium X-ray and endoscopy, since early cancer has a good prognosis, resulting in Japan having the best diagnostic capability for early gastric cancer worldwide. The 5-year survival rate of gastric cancer patients exceeds 60 % in Japan and is much higher than that in Europe and the US (20 %) because of this superior diagnosis of early gastric cancer. In February 2013, national health insurance coverage for Helicobacter pylori eradication therapy to treat H. pylori-associated chronic gastritis became available in Japan. H. pylori-associated gastritis leads to development of gastric and duodenal ulcers and gastric polyps. Therefore, providing treatment for gastritis is likely to substantially decrease the prevalence of both gastric and duodenal ulcers and polyps. Because treatment for H. pylori-associated gastritis, which leads to atrophic gastritis and gastric cancer, is now covered by health insurance in Japan, a strategy to eliminate gastric cancer-related deaths by taking advantage of this innovation was planned. According to this strategy, patients with gastritis will be investigated for H. pylori infection and those who are positive will receive eradication therapy followed by periodic surveillance. If this strategy is implemented, deaths from gastric cancer in Japan will decrease dramatically after 10-20 years.

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Figures

Fig. 1
Fig. 1
Five-year survival rate in Japan, US and Europe (%)
Fig. 2
Fig. 2
Changes of deaths of gastric cancer and liver cancer in Japan
Fig. 3
Fig. 3
Progress of H. pylori infection
Fig. 4
Fig. 4
Strategy for elimination of gastric cancer deaths in Japan
Fig. 5
Fig. 5
Changes in incidence of peptic ulcer in Japan
Fig. 6
Fig. 6
Anticipation of gastric cancer deaths with or without countermeasures in Japan
See this image and copyright information in PMC

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