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Helicobactor pylori pp 149–160Cite as

Are there reliable non-invasive approaches to assessing gastritis for epidemiologic studies?

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Abstract

Gastric adenocarcinoma is the second leading cause of cancer death worldwide; even with its incidence rates declining, gastric cancer is projected to be the eighth leading cause of all deaths by the year 2010 due to aging of the world population1. There are two major histological types of gastric cancer, intestinal and diffuse, both associated with Helicobacter pylori infection. A well-characterized chain of precancerous events — chronic gastritis, atrophy, intestinal metaplasia, and dysplasia — precedes the intestinal type2. In contrast, no clear precursor has been identified for the diffuse type. Today, close to 60% of the world adult population is chronically infected with H. pylori, with the majority found in developing countries and minority groups in developed countries3–7. Screening these high-risk populations for precancerous conditions (e.g. chronic atrophic gastritis) can lead to early intervention and consequently reduce mortality and severe morbidity caused by gastric cancer. Endoscopy is considered the gold standard for diagnosing chronic atrophic gastritis, but it is invasive and not widely available for epidemiologic studies conducted in many regions of the world, particularly in developing countries where H. pylori infection and gastric cancer are common. The ideal screening test should be efficient and economical, have acceptable follow-up evaluations, and be free of significant discomfort8. It should be highly sensitive so that the enrollment of high-risk subjects is maximized; at the same time, its positive predictive value has to be high enough to prevent subjects without the disease from getting involved in the study. To date, no such screening test exists. In this chapter, we will review several available screening assays that we and others have used, and discuss issues relevant to each method. Variations in sensitivity and specificity of the same assays across different studies will also be discussed. Finally, perspectives for developing new non-invasive assays will be addressed.

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Authors
  1. C.-J. Tsai
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  2. J. Parsonnet
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Editor information

Editors and Affiliations

  1. Division of Gastroenterology, McMaster University Medical Centre, 1200 Main Street West, L8N 3Z5, Hamilton, Ontario, Canada

    Richard H. Hunt (Professor of Medicine, Director) (Professor of Medicine, Director)

  2. Department of Gastroenterology and Hepatology, Academic Medical Centre, 9 Meibergdreef, 1105 AZ, Amsterdam, The Netherlands

    Guido N. J. Tytgat (Professor) (Professor)

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Tsai, CJ., Parsonnet, J. (2003). Are there reliable non-invasive approaches to assessing gastritis for epidemiologic studies?. In: Hunt, R.H., Tytgat, G.N.J. (eds) Helicobactor pylori. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-1763-2_15

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  • DOI: https://doi.org/10.1007/978-94-017-1763-2_15

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-90-481-5778-5

  • Online ISBN: 978-94-017-1763-2

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