Prediction of the 10‐year probability of gastric cancer occurrence in the Japanese population: the JPHC study cohort II

Abstract

Gastric cancer is a particularly important issue in Japan, where incidence rates are among the highest observed. In this work, we provide a risk prediction model allowing the estimation of the 10-year cumulative probability of gastric cancer occurrence. The study population consisted of 19,028 individuals from the Japanese Public Health Center cohort II who were followed-up from 1993 to 2009. A parametric survival model was used to assess the impact on the probability of gastric cancer of clinical and lifestyle-related risk factors in combination with serum anti-Helicobacter pylori antibody titres and pepsinogen I and pepsinogen II levels. Based on the resulting model, cumulative probability estimates were calculated and a simple risk scoring system was developed. A total of 412 cases of gastric cancer occurred during 270,854 person-years of follow-up. The final model included (besides the biological markers) age, gender, smoking status, family history of gastric cancer and consumption of highly salted food. The developed prediction model showed good predictive performance in terms of discrimination (optimism-corrected c-index: 0. pylori might be almost a necessary condition for gastric cancer development and that negativity of H. pylori infection in gastric cancer cases reflects the inability of the bacteria to develop on the mucosa of patients with severe atrophic

Gastric cancer and family history

“…However, this approach has a limitation since some patients with a single affected relative could, in future, be transferred to the group with two or more affected relatives. Recently, the Japanese National Cancer Center developed a prediction model for estimating the cumulative probability of gastric cancer occurrence based on a cohort of 19,028 individuals, using demographic and clinical variables, including a family history of gastric cancer and biological information (serum anti- H. pylori immunoglobulin G titers, levels of pepsinogen I and pepsinogen II) [64]. Further prospective studies at a nationwide level are necessary to identify individuals with a family history who are at very high risk of gastric cancer.…”

Receiver operating characteristic analysis of prediction for gastric cancer development using serum pepsinogen and Helicobacter pylori antibody tests

“…Based on previous studies related to gastric cancer screening [13–15], the predicative sensitivity and specificity of the combination method using PG I/II, PG I, and H. pylori antibody with a standard cut-off value were 94.0% and 34.3%, respectively. Even if other risk factors of gastric cancer were included in the model using PG I/II, PG I, and H. pylori antibody, the sensitivity and specificity of gastric cancer development were 96.5% and 28.8%, respectively [18]. Although the basic condition and follow-up times were different in these studies, the predicative accuracy of gastric cancer development was consistently low using the serum PG and H. pylori antibody tests.…”

“…Although the predication model has been developed based on these results, methods for risk stratification in connection with gastric cancer screening have not been conclusively identified [12, 18]. However, the adaptation of the serum PG and H. pylori antibody tests have been anticipated because these methods involve simple blood tests [13–17].…”

“…Sasazuki et al reported that the odds ratio for gastric cancer development of H. pylori infection with the gastric atrophy was higher to that of H. pylori infection and this was lower than that of H. pylori infection with positive result of CagA [11]. Charvat et al developed a prediction model for gastric cancer based on H. pylori infection and gastric atrophy with the risk factors related to lifestyle [18]. The strong association between gastric cancer and these risk factors suggested a high possibility of predicting gastric cancer incidence in the high-risk group detected by the serum PG and H. pylori antibody tests.…”

The ABC Method and Gastric Cancer: Evidence From Prospective Studies

“…The corresponding hazard ratios were 7.58 (95% CI, 4.16–13.79), 13.86 (95% CI, 7.76–24.75), and 14.09 (95% CI, 7.03–28.26) for Groups B, C, and D, respectively. 3 Using the model developed based on the ABC method and lifestyle factors, estimates of the 10-year probability of gastric cancer occurrence ranged from 0.04% (95% CI, 0.02%–0.10%) to 14.87% (95% CI, 8.96%–24.14%) for men and from 0.03% (95% CI, 0.02%–0.07%) to 4.91% (95% CI, 2.71%–8.81%) for women. 3 …”