- JAPAN SOCIETY OF NINGEN DOCK
- 健康医学 : 日本人間ドック学会誌 (ISSN:09140328)
- vol.17, no.1, pp.96-99, 2002-05-31
Gastric cancer, despite a recent decline in incidence, is still the second leading cause of cancer death in Japan. The measurement of serum pepsinogens has recently drawn attention as an alternative to photofluorography, given its lower cost and simplicity. The sensitivity of the pepsinogen test method has been reported as 80%, specificity 70%and positive predictive value 1.5%, respectively, from the results of the study of the Grant-in-Aid for Cancer Research from the Ministry of Health Labour and Welfare, Japan in 1998. We studied several trials (Toyama Prefecture, Adachi City, Tokyo Metropolitan Cancer Detection Center, Isesaki Municipal Hospital Oneday Human Dry Dock, etc) to compare the accuracy between the two screening methods for gastric cancer and to elucidate the usefulness of the pepsinogen test method under the support of the Grant in 2000. In summary, the pepsinogen test method is superior to the conventional Xray method, although these results show overestimated the relative sensitivity of pepsinogen test method compared with Xray method because pepsinogen test method was conducted as prevalent screening while Xray method was done as incidental screening. At present, no studies have directly examined whether the pepsinogen test method reduced gastric cancer mortality. Pepsinogen test method may be used as a screening test for high risk subjects with atrophic gastritis, rather than a tool for cancer itself, and systemic endoscopic surveillance of this group may be useful. These strategies would require empirical assessment, using mortality as an endpoint.