LEADING ARTICLE

The time to eradicate gastric cancer is now

D Y Graham¹, A Shiotani²

¹ Department of Medicine, Michael E DeBakey Veterans Affairs Medical Center, Departments of Medicine and Molecular Virology and Microbiology, Baylor College of Medicine, Houston TX, USA
² Health Administration Center, Wakayama University, Wakayama, Japan

Correspondence to:
Correspondence to:
Dr D Y Graham
Michael E DeBakey Veterans Affairs Medical Center, RM 3A-320 (111D), 2002 Holcombe Boulevard, Houston, TX 77030, USA; dgraham{at}bcm.tmc.edu

Worldwide gastric cancer remains one of the most common cancers, killing upwards of one million people each year. While the molecular pathogenesis remains unclear, infection with the bacterium Helicobacter pylori is considered a "necessary but not sufficient" cause, not surprisingly as gastric cancer has long been known to be associated with atrophic gastritis. Eradication of H pylori is expected to virtually eliminate gastric cancer and H pylori associated peptic ulcer within approximately 40 years and thus reduce overall mortality. In the USA, the incidence of gastric cancer in the general population is low, reflecting the change in the pattern of gastritis from atrophic to non-atrophic and in the low and decreasing prevalence of H pylori infection in the middle and upper classes. However, the plan for eradication of this important pathogen must be considered within the context of the prevalence and outcome within specific populations.

Keywords: Helicobacter pylori; gastric cancer; surveillance; pepsinogens; risk assessment

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