Clinical Application of Serum Pepsinogen I and II Levels for Mass Screening to Detect Gastric Cancer

Kazumasa Miki, Masao Ichinose, Koichi B. Ishikawa, Naohisa Yahagi, Masashi Matsushima, Nobuyuki Kakei, Shinko Tsukada, Masahiro Kido, Satoshi Ishihama, Yasuhito Shimizu, Takehisa Suzuki, Kiyoshi Kurokawa

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136 Citations (Scopus)


A considerable number of gastric cancers derive from stomach mucosa where chronic atrophic gastritis is severe and extensive. Based on the fact that the serum pepsinogen levels provide a precise measure of the extent of chronic atrophic gastritis, we have devised a mass screening method involving serum pepsinogen measurement to identify subjects at high risk of gastric cancer. In 1991, we screened 4,647 workers (male: 4,113, female: 534, mean age: 49.0 years) at a Japanese company using this method. Out of 875 subjects (18.8%) with a serum pepsinogen I level of less than 50 μg/liter and a pepsinogen I/II ratio of less than 3.0, 676 subjects (14.5%) were selected for further investigation by endoscopy. This led to the detection of four subjects (0.086%) with gastric cancer (three in an early stage) and four subjects with adenoma. The cancer detection rate of this new screening method was comparable, and in some respects superior, to that of the traditional barium X‐ray screening. Since the incidence of test‐positive subjects was as low as 10% amongst subjects aged less than 40, this screening method appears to be especially useful for screening of younger generations. The new method is less expensive than the traditional barium X‐ray and subjects experience little discomfort. Further, many serum samples can be quickly measured simultaneously. The results of this study have indicated that serum pepsinogen screening provides a valuable method for detecting gastric cancers.

Original languageEnglish
Pages (from-to)1086-1090
Number of pages5
JournalJapanese Journal of Cancer Research
Issue number10
Publication statusPublished - 1993 Oct
Externally publishedYes


  • Gastric cancer
  • Mass screening
  • Pepsinogen

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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