Asia-Pacific consensus guidelines on gastric cancer prevention |
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| Authors: | Fock Kwong Ming,Talley Nick,Moayyedi Paul,Hunt Richard,Azuma Takeshi,Sugano Kentaro,Xiao Shu Dong,Lam Shiu Kum,Goh Khean Lee,Chiba Tsutomu,Uemura Naomi,Kim Jae G,Kim Nayoung,Ang Tiing Leong,Mahachai Varocha,Mitchell Hazel,Rani Abdul Aziz,Liou Jyh Ming,Vilaichone Ratha-Korn,Sollano Jose Asia-Pacific Gastric Cancer Consensus Conference |
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| Affiliation: | Changi General Hospital, Singapore;;Mayo Clinic College of Medicine, Rochester, USA;;McMaster University Medical Center, Ontario, Canada;;University of Fukui, Fukui,;Jichi Medical University, Tochigi,;Kyoto University, Kyoto,;Kure Kyousai General Hospital, Kure, Japan;;Shanghai Institute of Digestive Disease, Shanghai,;University of Hong Kong, Hong Kong, China;;University of Malaya, Kuala Lumpur, Malaysia;;Chung Ang University College of Medicine,;Seoul National University College of Medicine, Seoul, Korea;;Chulalongkorn University Hospital, Bangkok,;Thammasat University Hospital, Pathumthani, Thailand;;University of New South Wales, Sydney, New South Wales, Australia;;University of Indonesia, Jakarta, Indonesia;;National Taiwan University Hospital, Taipei, Taiwan;and;University of Santo Tomas, Manila, Philippines |
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| 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. |
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| Keywords: | gastric cancer guidelines Helicobacter pylori prevention |
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