Reduction in gastric cancer mortality by screening based on serum pepsinogen concentration: A case-control study

Objective. Pepsinogen testing is widely used in Japan as a method of screening for gastric cancer. To evaluate the efficacy of this method, a case- control study was conducted in a rural town in Hiroshima prefecture, Japan, where no previous pepsinogen testing had been performed. Material and methods. Three age- and gender- matched control subjects were randomly selected for each of 41 individuals who had died of gastric cancer. The three control subjects were selected from individuals who were living in the same area as the patient when gastric cancer was diagnosed. Results. The odds ratios for death from gastric cancer among control subjects screened within 1 and 2 years before the individuals were diagnosed versus those not screened were 0.238 ( 95% confidence interval ( CI): 0.061 - 0.929), and 0.375 ( 95% CI: 0.155 - 0.905), respectively. Conclusions. The study results suggest that gastric cancer screening using the pepsinogen method may reduce mortality from gastric cancer.