1. Asia-Pacific consensus guidelines on gastric cancer prevention.
- Author
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Fock KM, Talley N, Moayyedi P, Hunt R, Azuma T, Sugano K, Xiao SD, Lam SK, Goh KL, Chiba T, Uemura N, Kim JG, Kim N, Ang TL, Mahachai V, Mitchell H, Rani AA, Liou JM, Vilaichone RK, and Sollano J
- Subjects
- Adenocarcinoma diagnosis, Adenocarcinoma epidemiology, Adenocarcinoma etiology, Anti-Bacterial Agents therapeutic use, Ascorbic Acid therapeutic use, Asia epidemiology, Dietary Supplements, Evidence-Based Medicine, Fruit, Genetic Predisposition to Disease, Helicobacter Infections complications, Helicobacter Infections diagnosis, Helicobacter Infections epidemiology, Helicobacter Infections microbiology, Humans, Incidence, Pacific Islands epidemiology, Pedigree, Pepsinogens analysis, Prevalence, Risk Assessment, Risk Factors, Sodium Chloride, Dietary adverse effects, Stomach Neoplasms diagnosis, Stomach Neoplasms epidemiology, Stomach Neoplasms etiology, Vegetables, Vitamins therapeutic use, Adenocarcinoma prevention & control, Anticarcinogenic Agents therapeutic use, Biomarkers, Tumor analysis, Helicobacter Infections drug therapy, Helicobacter pylori genetics, Mass Screening methods, Stomach Neoplasms prevention & control
- Abstract
Background and Aim: Gastric cancer is a major health burden in the Asia-Pacific region but consensus on prevention strategies has been lacking. We aimed to critically evaluate strategies for preventing gastric cancer., Methods: A multidisciplinary group developed consensus statements using a Delphi approach. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded., Results: Helicobacter pylori infection is a necessary but not sufficient causal factor for non-cardia gastric adenocarcinoma. A high intake of salt is strongly associated with gastric cancer. Fresh fruits and vegetables are protective but the use of vitamins and other dietary supplements does not prevent gastric cancer. Host-bacterial interaction in H. pylori infection results in different patterns of gastritis and differences in gastric acid secretion which determine disease outcome. A positive family history of gastric cancer is an important risk factor. Low serum pepsinogens reflect gastric atrophy and may be useful as a marker to identify populations at high risk for gastric cancer. H. pylori screening and treatment is a recommended gastric cancer risk reduction strategy in high-risk populations. H. pylori screening and treatment is most effective before atrophic gastritis has developed. It does not exclude the existing practice of gastric cancer surveillance in high-risk populations. In populations at low risk for gastric cancer, H. pylori screening is not recommended. First-line treatment of H. pylori infection should be in accordance with national treatment guidelines., Conclusion: A strategy of H. pylori screening and eradication in high-risk populations will probably reduce gastric cancer incidence, and based on current evidence is recommended by consensus.
- Published
- 2008
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