Screening for precancerosis and early gastric cancer in southern Jiangsu province / 中华健康管理学杂志

ABSTRACT

Objective To investigate the screening results and risk factors for precancerosis and early gastric cancer in southern Jiangsu province. Methods A total of 8 647 participants aged over 40 years were randomly sampled from 7 of 35 counties in Shengze District.Initial screening was performed with antibody testing to determine the pepsinogen Ⅰ/Ⅱratio(PGR),gastrin-17(G-17)level,and prevalence of Helicobacter pylori (Hp) infection, in addition to a questionnaire survey. Based on blood test results, participants were assigned to a low-,moderate,or high-risk group.Those assigned to moderate and high-risk groups were referred for endoscopy. In the low-risk group, 210 participants (30/county) were randomly selected for endoscopy.Results The overall prevalence of Hp infection was 51.2%.Female sex,body mass index,number of family members,and smoking were identified as risk factors based on the results of logistic regression, while educational level, drinking, and history of gastric cancer and digestive diseases were identified as protective factors.Based on the results of gastric functional testing, 2 391 participants(210 of 6 466 in the low-risk group and all participants in the moderate and high-risk groups) were referred for endoscopy.Of 2 381 participants,1 290 underwent endoscopy,with a response rate of 54.0%.According to the endoscopic and pathological findings, 925 participants were diagnosed with gastritis, 233 with atrophic gastritis and intestinal metaplasia,136 with intestinal metaplasia,32 with hyperplastic polyps,26 with mild dysplasia, 3 with moderate dysplasia, 6 with early gastric cancer,and 2 with advanced gastric cancer.The relevance ratio for gastric cancer was 92.5/100 000 in this specific region.Age,history of gastric cancer,Hp infection, over-/under-expression of PGI, PGR, and G-17 level were identified as risk factors for precancerous lesions. In the moderate and high risk groups, the prevalence of precancerous lesions was 24.6% in males and 24.4% in females,with adjustment using propensity score modeling.Conclusion The relevance ratio for early gastric cancer and precancerous lesions was slightly higher in those aged over 40 years in southern Jiangsu Province.It is essential to provide specific intervention and long-term follow-up for those screened for gastric cancer and precancerous lesions.