Gastric cancer diagnosis and prevention: Detecting precancerous at community level

Table 1 Age-standardized rates of gastric cancer incidence for a regions in 2020

Rating number	Region	Age-standardized (W) incidence rate per 100000
		Male	Female
1	Eastern Asia	32.5	13.2
2	Eastern Europe	17.4	7.1
3	South America	12.1	6.0
4	Western Asia	11.4	6.1
5	Southern Europe	10.2	5.0
6	Melanesia	9.9	6.2
7	Micronesia/Polynesia	9.7	5.5
8	Caribbean	9.0	5.0
9	Central America	8.7	6.1
10	Western Europe	8.2	3.8
11	South Central Asia	7.4	3.7
12	South-Eastern Asia	7.3	4.0
13	Australia/New Zealand	6.4	2.8
14	Northern Europe	6.2	3.1
15	Northern America	5.4	3.1
16	Northern Africa	5.4	3.5
17	Eastern Africa	4.9	4.2
18	Western Africa	4.8	3.5
19	Southern Africa	4.7	2.4
20	Middle Africa	4.6	3.8

Table 2 Serological criteria for the assessment of atrophic gastritis

No	Indicator	Normal	Signs of atrophic gastritis
1	Gastrin-17 (postprandial)	> 10 pmol/L	< 10 pmol/l-a sign of atrophic gastritis of the antrum
2	Pepsinogen-I	> 30 μg/L	< 30 μg/l-a sign of atrophic gastritis of the corpus
3	Anti-HP IgG	< 30 EIU	> 30-a sign of Helicobacter pylori positive gastritis

Table 3 Serological criteria for the assessment of atrophic gastritis

No	Indicator	Normal	Signs of atrophic gastritis
1	Ratio pepsinogen-I/pepsinogen-II	> 3	< 3-an integral sign of atrophic gastritis
2	Anti-HP IgG	< 30 EIU	> 30-a sign of Helicobacter pylori positive gastritis

Criteria for the assessment of atrophy markers are given for the GastroPanel^®biohit test panel.

Table 4 Assessment of gastric cancer risk in patients with atrophic gastritis

No.	The risk level of gastric cancer	The degree of stomach mucosal atrophy	Antrum (gastrin-17 pmol/L)	Corpus (pepsinogen-1 μg/L)
1	Low	No atrophy	> 10	> 25
2	Low	Mild	7-10	15-25
3	Low	Moderate	4-7	9-15
4	High	Severe	0-4	0-9

Table 5 Serological criteria for determining low and high risk of gastric cancer

Localization	Gastric corpus-PG-1 (μg/L)
Gastric antrum-G -17 (pmol/L)	Serology	0 (> 25)	1 (> 25)	2 (15-25)	3 (9-15)	4 (0-9)
	0 (> 10)	1	1	1	2	5
	1 (> 10)	1	2	2	2	5
	2 (7-10)	2	2	2	3	5
	3 (4-7)	2	2	4	5	10
	4 (0-4)	18	18	36	36	90

0: Normal stomach; 1: No atrophy; 2: Mild atrophy; 3: Moderate atrophy; 4: Severe atrophy.

Table 6 Determination of the stages of atrophic gastritis by classification Operative Link on Gastritis Assessment

Atrophy antrum	Corpus
	No atrophy	Mild atrophy	Moderate atrophy	Severe atrophy
No atrophy	Stage 0	Stage I	Stage II	Stage III
Mild atrophy	Stage I	Stage I	Stage II	Stage III
Moderate atrophy	Stage II	Stage II	Stage III	Stage IV
Severe atrophy	Stage III	Stage III	Stage IV	Stage IV

Table 7 Serological criteria the stages of atrophic gastritis Operative Link on Gastritis Assessment

Localization	Gastric corpus-PG-1 (μg/L)
Gastric antrum –G-17 (pmol/L)	Serology	> 25	15-25	9-15	0-9
	> 10	Stage 0	Stage I	Stage II	Stage III
	7-10	Stage I	Stage I	Stage II	Stage III
	4-7	Stage II	Stage II	Stage III	Stage IV
	0-4	Stage III	Stage III	Stage IV	Stage IV

Table 8 Histological criteria of atrophy according to visual analogue scale

The degree of atrophy in the biopsy	The percentage of loss of gastric glands
Mild atrophy	Less than 30% of the glands are lost
Moderate atrophy	Loss of glands is 30%-60%
Severe atrophy	Loss of more than 60% of the glands

Table 9 Gastric cancer risk structure

Risk factors for gastric cancer
Main risk factors	Additional risk factors
Age	Absence healthy lifestyle
Helicobacter pylori infection	Underweight or overweight significantly
Male gender	Periodontosis
Smoking
Farmer's profession
Low annual family income
Illiteracy
Alcohol consumption
Hot food consumption
Fast food intake salt consumption
History of gastritis
Peptic ulcer disease
Gallbladder disease, bile reflux
Genetic factors