Prevention Of Stomach Cancer Research Articles

Development and Assessment of a Helicobacter pylori Medication Adherence and Stomach Cancer Prevention Curriculum for a Chinese American Immigrant Population.

Chinese American immigrants are at increased risk for Helicobacter pylori infection and stomach cancer. Despite their increased risk, very few prevention strategies exist which target this vulnerable population. The purpose of this article is to present the stakeholder engaged development, review, assessment, refinement, and finalization of a H. pylori treatment adherence and stomach cancer prevention curriculum specifically designed to engage vulnerable, limited English proficient Chinese Americans in New York City.

A Study to Evaluate the Effectiveness of Self-Instructional Module on Knowledge Regarding Risk Factors and Prevention of Stomach Cancer among Professional Students at Selected Colleges, Bangalore

Background: Cancer is one of the most important causes of morbidity and the magnitude of the problem is gigantic. Gastric cancer is the second leading cause of cancer mortality in the world as well as in India. Majority of the patients are diagnosed at an advanced stage. It is widely held that 80% to 90% of stomach cancers may be attributable to environmental and life style factors such as tobacco, alcohol and dietary habits. Primary cancer prevention refers to avoiding cancer causing substances in the environment or dietary elements associated with increased risk.Methods: The research approach adopted for the study was experimental approach and research design selected for the study was experimental one group pre-test post-test design. Simple random sampling technique was used for the selection of 60 professional students. The tool used for the data collection was structured knowledge questionnaire, which had two sections. Section-A provides about socio-demographic data and Section-B deals with knowledge on risk factors and prevention of stomach cancer. Collected data was analyzed by using descriptive and inferential statistics in terms of frequencies, percentage, mean, standard deviation, chi-square values and ‘t’ test.Results: The result of this study showed that in pre-test 43(71.67%) of them had inadequate level of knowledge, 17(28.33%) of them had moderate level of knowledge and none of them had adequate level of knowledge regarding risk factors and prevention of stomach cancer whereas in post-test, 40(66.67%) of them had adequate level of knowledge, 20(33.33%) of them had moderate level of knowledge and none of them had inadequate level of knowledge regarding risk factors and prevention of stomach cancer. The enhancements mean score was 16.72±1.28.Conclusion: The study was found to be effective in improving the knowledge of professional students regarding risk factors and prevention of stomach cancer.Med Phoenix Vol.2(1) July 2017, 8-11

THE EFFECTIVENESS OF SCREENING FOR CANCER

Cancer screening literature was discussed in this review publication. Broad spectrum of studies was used to make conclusion about effectiveness of screening methods in reaching its major objectives, perspective of screening methods for several cancer types were also discussed. Qualitative assessment of studies was done. Cervical cancer, breast cancer and colorectal cancer screening was proved to be effective. Effectiveness of prostate and lung cancer screening as well as population-based stomach cancer prevention is also discussed. Negative and inconclusive results of screening studies of the other cancer types were also mentioned and perspectives for future diagnostics option for cancer screening were given.

Новое в изучении инфекции Helicobacter pylori и основные положения Согласительного совещания «Маастрихт-V» (2016)

Aim of review. To review in brief the reports of the XXIX international working meeting of the European Helicobacter pylori (H. pylori) and Microbiota Study Group (Magdeburg, 2016) and to discuss the key points of «Maastricht V» consensus meeting, devoted to diagnosis and treatment of infection. Key points. Association of H. pylori to both gastroenterological and non-gastrointestinal diseases and optimization of eradication therapy modes were discussed at the consensus conference. The special attention was paid for decreasing of infection burden and the stomach cancer prevention. New eradication therapy modes were presented for the regions with high and low H. pylori resistance to clarithromycin and metronidazole. It was demonstrated that clarithromycin resistance in Russia significantly varies in different regions and highest efficacy was observed for bismuth-based (in particular - bismuth tripotassium dicitrate) eradication modes. Conclusion. The guidelines of «Maastricht V» consensus meeting provide significant improvement of treatment results in H.pylori-infected patients as well as decrease of the risk of associated diseases (first of all - the stomach cancer).

Diet-Related Stomach Cancer Behavior Among Iranian College Students: A Text Messaging Intervention

Background:Stomach cancer is one of the five most common cancers in Iran. This study examined the effectiveness of a mobile telephone short-message service (SMS) based-education intervention using Health Belief Model (HBM) variables in improving dietary behavior in terms of stomach cancer prevention among a sample of Iranian female college students.Materials and Methods:In this quasi-experimental study, 124 female college students in the dormitories of Yazd University, Yazd, Iran were randomly selected and assigned to either the intervention (n=62) or the control group (n=62). Information (data) regarding HBM variables and dietary behavior related to stomach cancer prevention was collected by a self-administrated questionnaire. Forty eight messages were designed and sent to the participants’ phones in the intervention group during the 48-day intervention period. Two groups were followed-up one month after the intervention delivered via SMS.Results:There were significant differences in HBM variables (except for the perceived severity) and the preventive dietary behaviors for stomach cancer in the intervention group compared to the comparison group following the education intervention delivered via SMS.Conclusions:SMS-delivered nutrition education intervention can be a practical strategy to improve dietary behavior related to stomach cancer prevention.

Antibiotic and proton pump inhibitor therapy may help in prevention of stomach cancer

Antibiotic and proton pump inhibitor therapy may help in prevention of stomach cancer

Special issue: the 15th Taishotoyama International Symposium on Gastroenterology (2). Preface.

The Taishotoyama International Symposium on Gastroenterology has become an internationally known and highly acclaimed event. The 1980s, in which the Symposium was inaugurated, was a crucially important era for gastroenterology. Particularly, it was a time that made a great progress in identifying the causes, diagnosing and treating gastric and duodenal (peptic) ulcers that had been plaguing mankind. The Shay's balance theory was attractive. The theory explains that the gastric and duodenal mucosa is maintained in a normal state through a balance between the aggressive and defensive factors, and imbalance here causes mucosal damage. It was on the basis of this idea that H2 blockers and proton pump inhibitors were developed to suppress the secretion of gastric acid, the aggressive factor. Sofalcone and numerous other defensive factor potentiators were also developed as defensive factor boosters. These developments have significantly improved the speed of recovery from gastric and duodenal ulcers, and drastically reduced the number of cases requiring surgery. However, prevention of their recurrence was not achieved and this became the major problem with peptic ulcers. It goes without saying that this situation was reversed by the discovery of the Helicobacter pylori (Hp) bacterium. Barry Marshall and his colleagues won the Nobel Prize for this discovery. Eradication of this bacterium fundamentally changed peptic ulcer treatment modalities. Hp eradication is now contributing significantly to prevention of stomach cancer. It was a truly great innovation in the field of gastroenterology. Taishotoyama Symposiums contributed greatly to this era of sea-change. The Symposiums consisted of a wide-spectrum study groups covering gastrointestinal cancer, esophageal diseases, diseases of the small and large intestines as well as peptic ulcers. The number of participants to the Symposiums also increased. At each Symposium, around seven to ten distinguished professionals are invited from overseas, and the Symposiums have become internationally known as the forum for lectures, academic presentations and lively discussions. The magnitude of the schedule that we now see is impressive. The outcomes of these Symposiums were initially featured in the APT (Alimentary Pharmacology and Therapeutics) and latterly in the JGH (Journal of Gastroenterology and Hepatology)—they now form global information releases from Japan. Regrettably, this 15th Taishotoyama Symposium shall be the final one, and it has attracted major attention as an international Symposium in the overall medical field in Japan. Particularly, Japan ranks as a country that has made a highly significant contribution to gastroenterology. For young gastroenterologists, these Symposiums have been invaluable as a forum for discussion in English on a level with professionals from other countries. It is no exaggeration to state that it is these Symposiums that have now enabled them to proudly give presentations and hold discussions at the DDW conferences in the United States and Europe. Their presentations are also viewed as global cutting-edge in content, which alone is evidence of the major role the Symposiums have played in the field of gastroenterology. The good memories I have are truly too numerous to mention. The main Symposiums I enjoyed were those held in a hotel in Shimoda, and also in Hakone and Yokohama. I also recall as if only yesterday the splendid meeting in Washington DC. The Taisho Night event was also wonderful. The tradition of these excellent Symposiums was inaugurated by Professor Tadayoshi Takemoto, Professor Kenzo Kobayashi, Professor Eastwood and Professor Tarnawski. The Symposiums have subsequently been organized by Professor Masaki Kitajima and myself, and run by several promoters and secretaries. We always had around 150 attendees at each Symposium in the past. The constructive discussions in English and subsequent friendly exchanges have resulted in the creation of many professors. It is very sad that this shall be the last Symposium, but the march of the times has made it unavoidable. I thank Akira Uehara, the Chairman, and Akira Ohira, the President, and the other members of Taishotoyama Pharmaceutical Co., Ltd. for making these Symposiums so successful and for your worldwide contribution to gastroenterology. Lastly, I wish to express my appreciation to Asatsu-DK Inc. for arranging to feature the Symposiums in excellent international journals.

Formulating a comprehensive public health strategy for the prevention and control of stomach cancer

Formulating a comprehensive public health strategy for the prevention and control of stomach cancer

Stomach cancer involving esophagus. Diagnosis, treatment and prevention by specific methods.

Stomach cancer is a leader in the structure of cancer pathology in Ukraine and in the world. This paper summarizes own results and literature data on diagnosis, treatment and prevention of stomach cancer. Authors analyzed the experience and specific features of long-term treatment and diagnostic approach to patients with stomach cancer involving esophagus. Conducting pre-and postoperative cytostatic herbal therapy and cryosurgical operations during surgical treatment in patients with spread of tumor process allows to statistically significantly improve 3-and 5- year survival of patients.

Effect of Nutrition Education on Factors Influencing Food Choices in Relation to Prevention of Stomach Cancer among Undergraduates in South-West, Nigeria

Nutrition education intervention on factors influencing food choices was examined, aimed at preventing stomach cancer. Participants comprised of 398 undergraduates from 2 universities randomly classified into control and experimental groups. Intervention comprised of 8 weeks' lecture on making healthy food choices (one hour weekly). Data was collected u sing self-developed a nd self-administered questionnaires before and a ft er the intervention. Nutrition education significantly affected the perception of factors influencing food choices in the participants (p<0.05). The experimental group recorded a higher mean score of 40.23, p=0.00 and the control group's mean score was 37.58, p=0.42. Socio-economic and media factors significantly influenced the participants' food choices (p<0.05). The experimental group recorded higher mean scores in all variables tested; i mplying a better understanding of the factors of food choices in relation to stomach cancer. Nutrition education is efficacious in modifying food choices which may protect against stomach cancer.

Antioxidants and prevention of gastrointestinal cancers

Gastrointestinal cancers account for 20% of all incident cancers in the United States. Much work has been done to understand the role dietary factors play in the prevention of gastrointestinal cancers, yet evidence regarding the potential preventive effect of antioxidants is conflicting. This review highlights the recent studies investigating the associations between dietary antioxidants and cancers of the gastrointestinal tract. In-vitro and in-vivo studies in animals continue to support the hypothesis that antioxidants reduce the risk of gastrointestinal cancers. Results in human populations are not as supportive. Antioxidant nutrients and fruits and vegetables do not seem to confer protection against colorectal cancer, and certain antioxidants were found to increase the risk of distal colon cancer. Individual antioxidants also do not help prevent pancreatic cancer. Total antioxidant intake and plant-based foods seem promising for stomach cancer prevention, while vitamin C lowers the risk of esophageal cancer. Preventive effects for stomach and esophageal cancers were often limited to or stronger in smokers. Evidence is scarce regarding antioxidants and liver cancer. Antioxidants do not aid in the prevention of gastrointestinal cancers in the general population; however, they may act as chemopreventive agents for stomach and esophageal cancers, especially in high-risk populations.

Cranberry extract suppresses interleukin-8 secretion from stomach cells stimulated by Helicobacter pylori in every clinically separated strain but inhibits growth in part of the strains

It is known that cranberry inhibits the growth of Helicobacter pylori (HP). In human stomach, HP basically induces chronic inflammation by stimulating stomach cells to secrete interleukin (IL)-8 and other inflammatory cytokines, and causes stomach cancer, etc. The aim of this study was to investigate the inhibiting effects of cranberry on HP growth and IL-8 secretion from stomach cells induced by HP, using clinically separated HP strains. HP growth in liquid culture and on-plate culture was evaluated by titration after 2-day incubation and by agar dilution technique, respectively. For IL-8 experiments, MKN-45, a stomach cancer cell line, was incubated with HP for 24h and IL-8 in the medium was assayed by ELISA. Cranberry suppressed growth of the bacteria only in six of the 27 strains. Meanwhile, it suppressed IL-8 secretion in all the strains. The results may suggest a possible role of cranberry in prevention of stomach cancer by reducing gastric inflammation.

Effect of nutrition education on knowledge of nutrition in relation to prevention of stomach cancer among undergraduates in south-west, Nigeria

Stomach cancer is one of the common cancers worldwide including developing countries and is identified as one of the most lethal among the diet related cancers. In Nigeria, there is paucity of data and information about the prevalence of stomach cancer and without doubt this disease is on the increase. Youth engage in the consumption of western diets which have been identified in the literature as one factor that is closely associated with cancers. This shift to western diets by most youth may be due to lack of nutritional knowledge on the health consequences of their eating habits. In years to come, there may be an increase in the incidence of diet -related cancers and other chronic diseases if nutrition education is not put in place especially among the youth. Not many studies in Nigeria have focused on nutrition education of the youth in relation to the prevention of chronic diseases ; prominent among which is stomach cancer. This study is aimed at providing nutrition related education to university undergraduates in order to create awareness about nutrition with a view to preventing a rise in the incidence of stomach cancer and other chronic diseases. A quasi -experimental design was used for this study. Multi -stage sampling was used to select 436 male and female undergraduates between 16 -25 years old from two universities in south- west Nigeria (one control and one experimental ). The intervention consisted of lectures on nutritional factors of stomach cancer one hour weekly for 8 weeks and a placebo lecture on HIV/AIDS stigmatization for the control group. A validated self -structured questionnaire was used to collect the data for the pretest and posttest . Demographic characteristics were analyzed with percentages; variables were analyzed using t -test and ANCOVA set at 95% confidence interval. Nutrition education improved knowledge of nutrition in the participants (p&lt;0.00). The experimental group displayed higher nutrition knowledge compared to control . Level of study affected participants’ nutrition knowledge; students of lower level study performed better (p&lt; 0.00). Gender also affected participants’ nutrition knowledge; females performed better than males (p&lt;0.00). More nutrition education should be encouraged in school setting s to improve knowledge of nutrition in order to prevent a possible dietary risk of stomach cancer and other chronic diseases.

Pathogenetic effects of salted pork in an area of China with high-risk for stomach cancer.

To study the pathogenetic effects of salted pork (SP) (a special food in Zhuanghe City, a region of northern China that is a high-risk area for stomach cancer) on stomach cancer, and a provide scientific basis for the primary prevention of stomach cancer in this high-risk region. This study consisted of three distinct parts. The first part involved a study of SP mutagenicity and employed both the Ames test and micronuclei assay using V79 cells. The second part included a study of SP's effect on the gastric mucosa of residents in the Zhuanghe area who had consumed SP for more than ten years. Additionally, these studies involved an analysis of the dose effect relationship between SP and pathological changes in gastric mucosa, with a total of 300 cases analyzed. The third part of this study involved an observation of the mucosal lesions from experimental dogs by both gastroscopy and mucosal biopsy. Six healthy male dogs were selected, three were fed with SP, and the others served as controls. This study revealed that SP extract could mutate Salmonella typhimurium TA98 and induce an increase in both the micro nuclei rate (MNR) and micro nuclei cell rate (MNCR) of V79 at a dose range of 20-80 μL/mL. There were significant dose-effect relations between SP and either MNR or MNCR. Pathological changes in the gastric mucosa of local residents who had consumed SP were significantly different from those of the control group. In people who had consumed SP for ten years, mucosal lesions were found that contained evidence of necrosis and erosion; In those who consumed SP for ten-20 years, both hyperplasia and dysplasia were seen in addition to the above lesions. In individuals who had consumed SP for 20-30 years, severe dysplasia and malignant changes were found. Furthermore, SP had damaging effect on the gastric mucosa of dogs that were fed SP. The mucosal lesions became more severe with increased feeding time. SP is a strong mutagen and long-term SP exposure may result in repeated gastric mucosal damage and repair, ultimately leading to severe dysplasia and malignancy.

Genome-Wide Association Studies and Aggressive Surgery Toward Individualized Prevention, and Improved Local Control and Overall Survival for Gastric Cancer

Prevention and improved treatment can dramatically improve the poor prognosis of gastric cancer. Two pivotal studies in biomedical sciences and clinical research for the identification of genetic-factors-based primary prevention and surgical treatment of stomach cancer have most recently been reported from Japan. What are the clinical implications of these studies? In the field of risk-stratification-based personalized prevention, a novel gastric cancer candidate gene has been identified. A new genome-wide association study (GWAS) published in the June issue of Nature Genetics has demonstrated that genetic variants in the common, lowpenetrance PSCA gene are associated with increased risk of sporadic diffuse-type gastric cancer. Could genetic testing for these risk variants, or other new variants which will be identified by GWAS in the future, be used in the clinic? In the field of treatment, the results of a phase III randomized trial comparing D2 gastrectomy alone or D2 plus para-aortic lymph nodal dissection (PAND) in patients with advanced resectable gastric cancer have been reported in the July 31 issue of NEJM. The overall 5-year survival rate was around 70%, similar in both groups. This excellent result has been achieved by surgery alone. Given the poor prognosis of the disease in the West, despite the addition of modern adjuvant treatment to surgery, what are the applications of these Japanese results in the USA and Europe? Worldwide, gastric cancer, despite its declining incidence, still remains an important health problem, being the fourth most common cancer and the second most common cause of death. There is wide geographical variation. The annual age-standardized incidence rate in Japan ranges from 50 to 80 per 100,000 among men and from 20 to 30 per 100,000 among women while in the USA the figures are about one-tenth of those: 5.9 per 100,000 for men and 2.5 per 100,000 for women. We need effective prevention, early detection, and treatment strategies to reduce morbidity and mortality of the disease.

Host and environmental factors for gastric cancer in Babol, the Caspian Sea Coast, Iran

To clarify host and environmental factors for gastric carcinogenesis, we obtained information about gastric cancer mortality in Babol, in the North of Iran, and recruited 130 participants aged 30-80 years from the general population of Babol in 2004. A urea breath test, assessment of IgG antibodies to Helicobacter pylori, a pepsinogen test, a marker of chronic atrophic gastritis, and determination of urinary excretions of sodium and potassium were performed. Diet and lifestyle information was also obtained using a questionnaire. The stomach cancer mortality rate for men in Babol (38.2/10(5)) was found to be somewhat lower than that for Japanese men (45.1/10(5)), while the mortality for women (26.9/10(5)) was higher than for Japanese women (20.9/10(5)). Positive rates for the urea breath test were 77.5 and 81.8% for Iranian men and women, respectively. Helicobacter pylori IgG antibodies were present in 68.7 and 73.7% of Iranian men and women, respectively, both values being marginally higher than for Japanese. We also found 51.0 and 52.8% to be positive for a pepsinogen test, significantly higher than the Japanese values. Urinary excretions of salt and potassium in this population appeared approximately the same as the consumption in Japanese. The elevated gastric cancer mortality in both men and women in Babol seems, by and large, to be related to higher H. pylori infection rates and prevalence of chronic atrophic gastritis. Certain factors, including H. pylori DNA diversity, host factors and their interactions, together with the level of medical practice, prevalence of and access to secondary prevention of stomach cancer, may also be associated with the relatively high mortality.

Analysis of mortality of stomach cancer in China from 1990–1992

To assess the impact of stomach cancer on the Chinese population by epidemiological analysis of its distributional mortality. Data from 1990–1992 on stomach cancer mortality collected by a sampling survey involved one tenth of the total Chinese population. The crude mortality rate of stomach cancer in China was 25.2 per 105 (32.8 per 105 for males and 17.0 per 106 for females), which comprised 23.2% of the total cancer deaths from 1990 to 1992, making stomach cancer the leading cause of cancer death. The stomach cancer mortality rate of males was 1.9 times of that of females. The Chinese mortality rates of stomach cancer adjusted by the world standard population were 40.8 per 105 and 18.6 per 105 for males and females, which were 4.2–7.9 (formales) and 3.8–8.0 (for females) times of those in developed countries. Age adjusted mortality rates of stomach cancer in China have distinct geographical differences: form the lowest of 2.5 per 105 to the highest of 153.0 per 105 in the 263 selected sites, and 15.3 per 105 in urban areas and 24.4 per105 in rural areas, a difference of 1.6 times. The prevention and treatment of stomach cancer in China, especially in the countryside and the underdeveloped areas in the northwest, should be a long-term focus in preventing of cancers of the digestive system. Urgent measures for prevention and early detection of stomach cancer should be taken.

Premalignant lesions of the esophagogastric mucosa

Premalignant esophagogastric (EG) lesions develop against a background of chronic inflammation, called a premalignant condition. For esophageal squamous cell cancer, causal factors include alcohol, tobacco, hot beverages, oral consumption of opioids, and probably infectious agents. For adenocarcinoma in the Barrett’s esophagus (BE), gastroesophageal reflux disease (GERD) is the principal causal factor. At the EG junction, adenocarcinoma arises either from the esophagus or from the proximal stomach (cardia). In the distal stomach, chronic gastritis with atrophy is the premalignant condition related to Helicobacter pylori infection. A high intake of salt and low intake of antioxidants also play a role. The histopathology of EG premalignant lesions is now included in the groups low-grade and high-grade intraepithelial neoplasia (IEN) of the revised Vienna classification. Endoscopy is the gold standard for detection of the lesions at the preclinical stage and their appearance is described in subtypes of the type 0 of the Japanese classification, with a distinction between protruding and nonprotruding lesions. There is a priority for primary prevention of causal factors rather than for mass screening, which is justified only in Japan for the prevention of stomach cancer. The trend to early detection of premalignant lesions justifies the development of mini-invasive endoscopic procedures of treatment.

Systematic review: green tea and gastrointestinal cancer risk.

Gastrointestinal cancer is one of the leading causes of cancer mortality in the world. Therefore, numerous efforts are being made to find chemoprotective substances able to reduce its incidence. Amongst these, green tea, one of the most popular beverages world-wide, has been reported to provide protective effects against gastrointestinal cancer. To critically evaluate all epidemiological studies reporting an association between green tea consumption and a reduced risk of gastrointestinal cancer. Epidemiological studies of green tea consumption in relation to gastrointestinal cancer or preneoplastic lesions were identified through computerized literature searches using the following databases: Medline (Pubmed), Embase, Amed, CISCOM, Phytobase and Cochrane Library. Only epidemiological studies indicating the type of tea (green tea) and the site of either cancer or precancerous lesions (stomach or intestine) were included. No language restrictions were imposed. Twenty-one epidemiological investigations met our inclusion/exclusion criteria. These studies seemed to suggest a protective effect of green tea on adenomatous polyps and chronic atrophic gastritis formations. By contrast, there was no clear epidemiological evidence to support the suggestion that green tea plays a role in the prevention of stomach and intestinal cancer.

Introduction

Since the sudden appearance of Helicobacter pylori in 1983, the perception of upper gastrointestinal tract diseases such as peptic ulcers has radically changed. The idea that most gastroduodenal diseases are infectious can indeed be called a paradigm shift. This ingenious idea, proposed by Warren and Marshall, marked what can be coined a revolutionary turnaround in the perception of upper gastrointestinal tract diseases. It is no doubt that the greatest discovery of the last century, tantamount to the discovery of hepatitis B and C virus strains that cause hepatitis, cirrhosis, and hepatocellular carcinoma, and is indeed an achievement that deserves the Nobel Prize. As a result, the treatments of peptic ulcers, said to be constitutional and destined to recur, have been transformed into treatments designed for infections. Most peptic ulcers, which have tormented humankind throughout our history, are now maladies that can be easily cured clinically. Japan is known for its universally high rate of stomach cancer; however, we are faced with the urgent need to clarify the relationship between H. pylori and stomach cancer. Various studies have brought to light that this bacteria does cause chronic gastritis, in particular, atrophic gastritis, but there is no sound evidence showing that it directly causes stomach cancer as of yet. Indeed, the WHO has established the epidemiological connection of the bacteria, but I think that this serves no proof of direct causal associations. The truth about the sequence of infection by H. pylori, atrophic gastritis, intestinal metaplasia, and finally stomach cancer must be ascertained in Japan for its troublingly high stomach cancer rate. Against this background, we set up the MAGIC Project to investigate the connections between H. pylori and gastritis or stomach cancer. MAGIC stands for ‘Mucosta Against Gastric Inflammation & Carcinogenesis’. The issue that must be resolved now is: ‘Does H. pylori infection cause stomach cancer directly, and can eliminating this bacteria cure atrophic gastritis and thus prevent stomach cancer?’ To date, numerous cytoprotective agents have been developed and used clinically, predominantly in Japan. In the age of the H. pylori, we find ourselves questioning the significance of these drugs, and unwillingly admitting the crisis of cytoprotective agents. In this ‘age’, we are thrust with the fundamentally grave task of questioning the roles these agents play, and if they are really needed. The answers to these questions must of course be based on evidence. The MAGIC Project therefore decided to take up rebamipide (Mucosta), the representative cytoprotective agent, and investigate its roles in the stomach cancer sequence, regarding: whether rebamipide is able to prevent inflammations caused by H. pylori; if it can help heal mucosal atrophy; and if, as a result, it can contribute to the prevention of stomach cancer in some way. Rebamipide suppresses or eliminates the production of active oxygen species and suppresses the release of inflammatory cytokines from H. pylori-infected gastric mucosa, thereby controlling gastric inflammation. This ambitious study aims to clarify if such actions contribute to the recovery of the gastric mucosa after elimination of the bacteria, and finally to the prevention of stomach cancer. This study was continued for 4 years, mostly in 20 facilities around the world. The results were presented at a conference held during the Digestive Disease Week (DDW) meeting in San Francisco in 2002. This Alimentary Pharmacology and Therapeutics supplement issue carries the proceedings of those presentations. Most of these presentations deal with fundamental studies, but all are directly connected to clinical efficacy, and thus are considered to contribute to evidence-based medicine. I would first like to express my gratitude to Professor Pounder of Alimentary Pharmacology and Therapeutics for helping with the editing of this issue, and my respects to the many researchers who continued working on these long-term studies. Finally, I would like to express my heartfelt thanks to Otsuka Pharmaceutical Co., Ltd. for supporting this project.