Serum Pepsinogen Test Research Articles

A study of gastric cancer mass screening using the serum pepsinogen test in combination with the barium X-ray method in Maniwa City, Okayama Prefecture

A study of gastric cancer mass screening using the serum pepsinogen test in combination with the barium X-ray method in Maniwa City, Okayama Prefecture

Evaluation of the utility of the serum pepsinogen test and the optimum interval between tests in stomach cancer screening

Evaluation of the utility of the serum pepsinogen test and the optimum interval between tests in stomach cancer screening

Gastric cancer screening using the serum pepsinogen test method

The current status of gastric cancer screening, worldwide, as well as in Japan, using the serum pepsinogen test method, was reviewed. We performed a metaanalysis of sensitivity and specificity results from 42 individual studies (27 population-based screening studies: n = 296 553 and 15 selected groups: n = 4 385). Pooled pairs of sensitivity and false-positive rates (FPr) for pepsinogen I level < or = 70 ng/ml; pepsinogen I/II ratio < or = 3, had a sensitivity of 77%/FPr27%. The positive predictive value varied between 0.77% and 1.25%, and the negative predictive value varied between 99.08% and 99.90%. Therefore, we concluded that the definition of the pepsinogen test should include the pepsinogen I/II ratio, as consistency was obtained for both the population-based studies and the selected groups for those studies that used pepsinogen I serum levels together with the pepsinogen I/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Individuals testing positive for extensive atrophic gastritis by serum pepsinogen levels undergo endoscopic examination to test for the presence of gastric cancer. We should increase the efficacy and cost-effectiveness of the gastric cancer screening system, by the identification of groups, at low-risk, as well as those at high-risk, of developing gastric cancer, using a combination of assays of serum Helicobacter pylori antibody titers and the concentration of pepsinogen I and II. In conclusion, the pepsinogen test method can be used as a screening test for high-risk subjects, rather than as a tool for screening for cancer itself. I hope that this pepsinogen test method will become a world standard for gastric cancer prevention in the near future, in other countries, as well as in Japan.

The Serum Pepsinogen Test as a Predictor of Gastric Cancer

The authors examined whether a serum pepsinogen test (SPT) based on the combination of the serum pepsinogen I level and pepsinogen I/II ratio is a good predictor of gastric cancer occurrence in a general Japanese population. A total of 2,446 subjects aged > or =40 years were classified into negative, positive, and strong-positive SPT groups and were followed prospectively for 14 years (1988-2002). Compared with that for the negative SPT group (26 men, 10 women), gastric cancer incidence increased significantly for both men (n = 17; age-adjusted hazard ratio = 4.56, 95% confidence interval: 2.42, 8.60) and women (n = 6; age-adjusted hazard ratio = 5.84, 95% confidence interval: 2.00, 17.11) in the strong-positive SPT group. It was also significantly higher in the positive SPT group for men (n = 23; age-adjusted hazard ratio = 3.91, 95% confidence interval: 2.23, 6.86). These associations did not attenuate even after adjustment for other comprehensive risk factors. Stratified analysis revealed significant associations between the SPT and development of intestinal-type gastric cancer as well as of cancer in both Helicobacter pylori-negative and -positive subjects. These findings suggest that the SPT can serve as a predictor of intestinal-type gastric cancer, irrespective of H. pylori infection.

Gastric cancer screening of a high‐risk population in Japan using serum pepsinogen and barium digital radiography

With the aim of developing more efficient gastric cancer screening programs for use in Japan, we studied a new screening program that combines serum pepsinogen (PG) testing and barium digital radiography (DR). A total of 17 647 middle-aged male subjects underwent workplace screening over a 7-year period using a combination of PG testing and DR. This program's effectiveness, as well as other characteristics of the program, was analyzed. Forty-nine cases of gastric cancer were detected (comprising 88% early cancer cases). The detection rate was 0.28%, and the positive predictive value was 0.85%. The PG test detected 63.3% of cases, DR detected 69.4% of cases, and both tests were positive in 32.7% of cancer cases. The two methods were almost equally effective, and were considerably more effective than conventional screening using photofluorography. Each screening method detected a distinct gastric cancer subgroup; the PG test efficiently detected asymptomatic small early cancer with intestinal type histology, while DR was efficient at detecting cancers with depressed or ulcerated morphology and diffuse type histology. The cost for the detection of a single cancer was much less than that for conventional screening. In fact, it is possible to further reduce the cost of detecting a single cancer to a cost comparable to that of surgically resecting a single gastric cancer. Thus, it is probable that a highly efficient gastric cancer screening system can be implemented by combining the two screening methods. Such a screening program would be beneficial in a population at high risk for gastric cancer.

A comparative study of mass screenings for gastric cancer: indirect gastrofluororadiography and the serum pepsinogen test

A comparative study of mass screenings for gastric cancer: indirect gastrofluororadiography and the serum pepsinogen test

Influences of the absence of random assignment of bids on estimating willingness to pay using a discrete-choice question.

This study examined the influences of the interaction between a bid and the respondent's characteristics due to insufficient random assignment of bids on the estimation of willingness to pay (WTP) using data from a discrete-choice question. A contingent valuation survey of 152 examinees undergoing X-ray testing for gastric cancer screening was conducted, and the median and mean WTP for the serum pepsinogen test were estimated using a logistic regression model to which the interaction terms between the bid and the respondent's characteristics, which included gender, age, annual income, frequency of prior use of a gastric cancer screening program, and perceived health, were added. There were remarkable differences in the estimated WTP according to whether the interaction term of annual income, to which the bids had failed to be assigned randomly and which had been positively correlated with the bid, was added in the model. It is suggested that it may be necessary to check if the bids were randomly assigned to the respondent's characteristics and, when correlations with the bid are found, to adjust their interaction effects.

A Study of Gastric Mass Survey in the employee using Serum Pepsinogen Test (Second Report)

A Study of Gastric Mass Survey in the employee using Serum Pepsinogen Test (Second Report)

Examination of a gastric cancer high-risk group in a mass screening of the stomach using interleukin 1-beta polymorphism an alysis and the serum pepsinogen test

Examination of a gastric cancer high-risk group in a mass screening of the stomach using interleukin 1-beta polymorphism an alysis and the serum pepsinogen test

Utility of serum pepsinogen test in combination with upper gastrointestinal series in screening for stomach cancer

Utility of serum pepsinogen test in combination with upper gastrointestinal series in screening for stomach cancer

Evaluation of the serum pepsinogen test in operative cases of gastric cancer

Evaluation of the serum pepsinogen test in operative cases of gastric cancer

Five years’ follow-up of participants in stomach cancer screening by serum pepsinogen test method

Purpose: A new method of serological screening for gastric cancer by measuring serum pepsinogen (PG) levels has recently been introduced in Japan. This method can identify individuals with chronic atrophic gastritis at high risk of gastric cancer. To assess the reduction of gastric cancer mortality among participants in PG gastric cancer screening, we conducted a 5-year follow-up study.

Usefulness of gastric cancer screening using the serum pepsinogen test method

Objective The measurement of serum pepsinogen has recently gained attention as a candidate for a new screening test for gastric cancer. This method is particularly attractive given its lower cost and simplicity to administer relative to photofluorography. To compare the accuracy between the two screening methods, and to elucidate the usefulness of the serum pepsinogen test method, we performed this study. Methods Mass screening for gastric cancer was performed using both the x-ray and pepsinogen test methods simultaneously on 286 company employees. The number of tests conducted was 5567 in total. The mean age was 48 yr in both men and women. Informed consent was taken individually. Fasting blood samples were collected, and measurement of the serum pepsinogen concentration was carried out by immunoradiometric assay. Results The percentage of those screened, who needed further examination was 11.7% for the x-ray method and 23.6% for the pepsinogen test method. The percentage of those who required further investigation, as the second step of screening, using endoscopy, was 55.4% for the x-ray method and 51.9% for the pepsinogen test method, respectively. Ten gastric cancers were detected in total. The incidence was 0.05% in the x-ray method and 0.18% in the pepsinogen test method. The rate of early gastric cancer to advanced gastric cancer was 9 to 1, that is, 90% were in the early stages. The positive predictive value was 0.8% in the x-ray method and 1.4% in the pepsinogen test method. Conclusions The pepsinogen test method can be used as a screening test for high-risk subjects with atrophic gastritis, rather than as a tool for cancer itself. Systemic endoscopic surveillance of this group is also useful.

Gastric cancer screening using the serum pepsinogen test method

The current status of gastric cancer screening, worldwide, as well as in Japan, using the serum pepsinogen test method, was reviewed. We performed a metaanalysis of sensitivity and specificity results from 42 individual studies (27 population-based screening studies: n = 296 553 and 15 selected groups: n = 4 385). Pooled pairs of sensitivity and false-positive rates (FPr) for pepsinogen I level < or = 70 ng/ml; pepsinogen I/II ratio < or = 3, had a sensitivity of 77%/FPr27%. The positive predictive value varied between 0.77% and 1.25%, and the negative predictive value varied between 99.08% and 99.90%. Therefore, we concluded that the definition of the pepsinogen test should include the pepsinogen I/II ratio, as consistency was obtained for both the population-based studies and the selected groups for those studies that used pepsinogen I serum levels together with the pepsinogen I/II ratio for screening for gastric cancer in high-incidence regions other than Japan. Individuals testing positive for extensive atrophic gastritis by serum pepsinogen levels undergo endoscopic examination to test for the presence of gastric cancer. We should increase the efficacy and cost-effectiveness of the gastric cancer screening system, by the identification of groups, at low-risk, as well as those at high-risk, of developing gastric cancer, using a combination of assays of serum Helicobacter pylori antibody titers and the concentration of pepsinogen I and II. In conclusion, the pepsinogen test method can be used as a screening test for high-risk subjects, rather than as a tool for screening for cancer itself. I hope that this pepsinogen test method will become a world standard for gastric cancer prevention in the near future, in other countries, as well as in Japan.

A comparative Study on serum pepsinogen test and X-ray examination used as a gastric cancer screening for company employees

A comparative Study on serum pepsinogen test and X-ray examination used as a gastric cancer screening for company employees

Gastric cancer detected by a combined method of indirect barium X-ray scan and serum pepsinogen test

Gastric cancer detected by a combined method of indirect barium X-ray scan and serum pepsinogen test

Improvement of the detection rate of gastric cancer using the serum pepsinogen test method.

Improvement of the detection rate of gastric cancer using the serum pepsinogen test method.

EFFICACY OF SERUM PEPSINOGENS IN THE PREDICTION OF ENDOSCOPIC FEATURES OF GASTRITIS

ObjectiveThe efficacy of serum pepsinogen (PG) test is widely accepted as a screening test to select persons for endoscopy in the diagnosis of gastric cancer. In this study, we would like to examine whether serum PG levels give us information on endoscopic findings of gastric mucosa.Materials and methodsThe serum level of PG++ and PG+− and the PG+/PG− ratio were compared with endoscopic 13C‐urea breath. H.pylori status was defined as an increase in the intragastric 13CO2/12CO2 ratio of 10% over baseline. Intestinal metaplasia was made visible as the purple‐stained area using a 0.05% crystal violet spraying method. PG level of less than 70μg/L and I PG+/PG− ratio of less than 3 was adopted for a (+) result, and PG level of less than 30μg/L and a PG+/PG− ratio of less than 2 for a (++) result.ResultsPrevalence of endoscopic features and H. pylori infection in different groups classified by serum PG tests.ConclusionsLintestinal metaplasia was identified in more than 80% of PG positive patients. The prevalence of linear reddness and raised erosion in the antrum were higher in PG (‐) group than in PG(+) and (++) groups. H. pylori‐positive rate was the highest in PG (+) group.

Screening for gastric cancer in Japan.

In Japan, mass screening for gastric cancer with photofluorography was initiated in 1960. At present, over 6 million people are screened annually. The sensitivity and specificity of photofluorography are 70%-90% and 80%-90%, respectively. The 5-year survival rate is 15%-30% better in screen-detected cancers than in symptom-diagnosed cases. Although no randomized controlled trials have been reported, cohort and case-control studies generally showed a decreased risk of mortality from gastric cancer in the screened subjects. The summary odds ratio (95% confidence interval) of three case-control studies for ever screened versus never screened subjects was 0.39 (0.29-0.52) for men and 0.50 (0.34-0.72) for women. Substantial evidence indicates that the Japanese screening program with photofluorography is effective in reducing the mortality from gastric cancer. The measurement of serum pepsinogens has recently drawn attention as an alternative to photofluorography, given its lower cost and simplicity. Some studies have suggested a comparable accuracy for the two methods. However, these investigations may have overestimated the relative sensitivity of serum pepsinogen testing compared with photofluorography, because serum pepsinogen testing was conducted as prevalent screening, while photofluorography was done as incident screening. Furthermore, no studies have directly examined whether the screening with serum pepsinogens reduced gastric cancer mortality. Therefore, at present, evidence is insufficient to determine the benefit of this program.

Mass Screening for Gastric Cancer using Serum Pepsinogen Test for Three Years in Takasaki City and Proposals New Mass

Mass Screening for Gastric Cancer using Serum Pepsinogen Test for Three Years in Takasaki City and Proposals New Mass