The serum pepsinogen test as a predictor of gastric cancer : The hisayama study

• Published in: American journal of epidemiology Vol. 163; no. 7; pp. 629 - 637
• Main Authors: OISHI, Yoshinori, KIYOHARA, Yutaka, MATSUMOTO, Takayuki, IIDA, Mitsuo, KUBO, Michiaki, TANAKA, Keiichi, TANIZAKI, Yumihiro, NINOMIYA, Toshiharu, DOI, Yasufumi, SHIKATA, Kentaro, YONEMOTO, Koji, SHIROTA, Tomoko
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 01.04.2006; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Aged, 80 and over; Analysis. Health state; Biological and medical sciences; Cancer; Epidemiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Helicobacter; Helicobacter Infections - epidemiology; Helicobacter pylori; Humans; Incidence; Japan - epidemiology; Male; Medical sciences; Medical tests; Middle Aged; Miscellaneous; Pepsinogens - blood; Predictive Value of Tests; Proportional Hazards Models; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression Analysis; Risk Factors; Seroepidemiologic Studies; Stomach; Stomach Neoplasms - blood; Stomach Neoplasms - epidemiology; Stomach Neoplasms - microbiology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Japan; Human; Spirillales; Spirillaceae; Malignant tumor; Pepsinogen; cohort studies; gastritis; Stomach cancer; Epidemiology; Gastritis; Atrophy; Helicobacter pylori; atrophic; Helicobacter pylori; pepsinogens; stomach neoplasms; Cohort study; Clinical biology; Digestive diseases; Bacteria; Serum; Predictive factor; Public health; Gastric disease
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwj088

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.