American Journal of Epidemiology Advance Access published online on January 27, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj088
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1 Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
* To whom correspondence should be addressed. 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
Received May 23, 2005
Accepted November 8, 2005
ORIGINAL CONTRIBUTIONS
The Serum Pepsinogen Test as a Predictor of Gastric Cancer
Yoshinori Oishi 1 *,
Yutaka Kiyohara 1,
Michiaki Kubo 1,
Keiichi Tanaka 1,
Yumihiro Tanizaki 1,
Toshiharu Ninomiya 1,
Yasufumi Doi 1,
Kentaro Shikata 1,
Koji Yonemoto 1,
Tomoko Shirota 2,
Takayuki Matsumoto 1,
and
Mitsuo Iida 1
2 Department of Health Promotion, School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan
Yoshinori Oishi, E-mail: oishi{at}intmed2.med.kyushu-u.ac.jp
Abstract 
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.
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