Validation of the pepsinogen test method for gastric cancer screening using a follow-up study
- 452 Downloads
Serum pepsinogen (PG) measurement has been used for gastric cancer screening since the 1990s. However, there are no reports comparing the screening validity of the PG test method with that of conventional X-ray examination directly in the same population, using a follow-up study.
From April 2000 to March 2001, 12 120 residents of Osaka Prefecture, who underwent opportunistic screening at a medical checkup organization in Osaka city (hereafter, “the organization”), were enrolled. They received both a barium meal examination and PG test simultaneously. All the participants were followed up for a 1-year period after the screening. For the participants advised to undergo endoscopic examination, the results of those who were examined at the organization were tallied. The other participants were checked using the Osaka Cancer Registry (hereafter, “the registry”).
Of the 12 120 participants, 493 (4.1%) were positive with the PG method and 728 (6.0%) were positive with the X-ray method. Fifty-four (0.4%) were positive for both methods. Thirteen gastric cancer cases were diagnosed by successive esophagogastroduodenoscopies at the organization. Six additional gastric cancer cases were identified by record linkage with the registry. The sensitivity, specificity, and positive predictive values of the PG method with a PGI cutoff level of ≤30 ng/ml and PGI/PGII ratio of ≤2.0 were 36.8%, 96.0%, and 1.4%, respectively. These values for the direct X-ray examination were 68.4%, 94.1%, and 1.8%, respectively.
The PG test method alone with a PGI cutoff level of ≤30 ng/ml and PGI/PGII ≤ 2.0 is not appropriate for gastric cancer screening.
Key wordsPepsinogen Gastric cancer Screening Follow-up study
- 1.The Editorial Board of the Cancer Statistics in Japan. Cancer Statistics in Japan 2008. Tokyo: Foundation for Promotion of Cancer Research; 2008.Google Scholar
- 12.Statistics and Information Department, Ministry of Health, Labour, and Welfare. National reports on cancer screening programs 2004. Tokyo: Health and Welfare Statistics Association; 2006.Google Scholar
- 14.Sugawara N, Hirasawa Y, Morimoto T, Sibuki S, Kogane T, Sato H, et al. An investigative report about health state of old age groups at first screening for gastric mass survey (in Japanese). J Gastroenterol Mass Surv 1992;95:184–186.Google Scholar
- 15.Fukao A, Hisamichi S, Takano A, Sugawara N. Accuracies of mass screening for gastric cancer-test sensitivity and program sensitivity (in Japanese). J Gastroenterol Mass Surv 1992;97:59–63.Google Scholar
- 16.Ishida T, Suematsu T, Obayashi K, Takada Y, Kimura S, Suematsu C. Measurement of accuracy of stomach mass screening by population-based cancer registration (in Japanese). J Gastroenterol Mass Surv 1994;32:9–16.Google Scholar
- 17.Hattori M, Fujita M, Hosokawa O, Yamazaki S. A clinicopathological evaluation of false negative cases in gastric cancer mass survey (in Japanese). J Gastroenterol Mass Surv 1998;36:468–475.Google Scholar
- 18.Abe S, Shibuya D, Noguchi T, Shimada T. An estimate of the false-negative rate of mass-screening for gastric carcinoma (in Japanese). J Gastroenterol Mass Surv 2000;38:475–482.Google Scholar