Current efforts and vision of X-ray gastric cancer screening considering <i>H. pylori</i> eradication in Yamagata prefecture

<p>We conducted a familiarization and standardization of Helicobacter pylori (H. pylori) eradication program in Yamagata Prefecture and established the Yamagata Prefecture H. pylori study group when H. pylori eradication was covered by the National Health Insurance in November 2000. Subsequently, we conducted an 8-year prospective cohort study of the effect of H. pylori eradication on gastric cancer suppression, which showed a 40% reduction in gastric cancer in patients who underwent H. pylori eradication compared to those who did not. The effect of H. pylori eradication was also confirmed by a collaborative study between the Yamagata City Medical Association and Yamagata University between 2010 and 2011. The results revealed that X-ray gastric cancer screening combined with the ABC classification detected 3 times more gastric cancer than that of X-ray screening alone. These results prompted Yamagata City to continue the X-ray gastric cancer screening program combined with the ABC classification including financial support for the ABC class evaluation and H. pylori eradication. This program re-confirmed the usefulness of gastric cancer screening and the successful H. pylori eradication in infected patients over four years and provided opportunities to examine the present status and identify any outstanding issues. In 2014, WHO/IARC published a report recommending H. pylori eradication for gastric cancer prevention, and the Ministry of Health, Labor, and Welfare published a revised “Japanese Guideline for Gastric Cancer Screening” in 2016. Following these publications, Digestive System Disease Screening Central Committee of Yamagata Prefecture Medical Association also established a screening system, which aimed to provide H. pylori eradication for gastric cancer prevention education to patients diagnosed with chronic gastritis to encourage them to undergo H. pylori eradication for the reduction of gastric cancer risk. The diagnosis was based on the categorized criteria for the gastric mucosal pattern using the upper GI series defined by the Japanese Society of Gastrointestinal Cancer Screening (category 2 “chronic gastritis”).</p>