| Theme | Pepsinogen -- Basic, Clinical Implications, and Epidemiology | |
|---|---|---|
| Title | Annual Reports (1997-2000) of the Research Committee for Examination on Study of Gastric Cancer Screening Systems Using Serum Pepsinogen | |
| Publish Date | 2002/10 | |
| Author | Masahiko Sasajima | First Department of Internal Medicine, Toho University School of Medicine |
| Author | Reiko Hoshina | First Department of Internal Medicine, Toho University School of Medicine |
| Author | Kazumasa Miki | First Department of Internal Medicine, Toho University School of Medicine |
| [ Summary ] | Chronic atrophic gastritis is a well-known type of precancerous lesion. It is widely accepted that serum pepsinogen levels reflect the functional and morphologic status of the stomach mucosa. Serum pepsinogen was introduced for cancer screening to identify individuals with extensive atrophic gastritis. The study group for "Gastric Cancer Screening Systems, Using Serum Pepsinogens" organized by the National Cancer Fund of Japan from 1997-2000, advocated that individuals should be considered to have tested positive for extensive atrophic gastritis when their pepsinogen levels are PG I<70micro-g/l, I/II ratio<3.0. Number of 11,707 volunteers underwent endoscopic examinations to test for the presence of gastric cancer. The study showned that the positive predictive value of the serum pepsinogen test was 1.5%. Results of the serum pepsinogen test as a primary screening tool demonstrate that the cancer detection rate for screening with the serum tests is superior and more cost effective as compared to the conventional barium X-ray mass screening. Serum pepsinogen test screening is especially useful in detecting small asymptomatic cancers, which are relatively difficult to detect using barium X-rays. However, conventional screening is good for detecting symptomatic cancers. The cancers detected by the two screening methods are different in related to morphological and histrogical types, so the combination of the two methods has greatly improved screening efficiency and made them more cost effective. |
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