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Author(s): Castro, C
Dinis-Ribeiro, M
Rodrigues, ANG
Calheiros, T
Santos, T
Pereira, P
Ramos, M
Cunha, H
Andrade, M
Costa, A
Sá, L
Antunes, L
Bento, MJ
Lomba-Viana, R
Title: Western long-term accuracy of serum pepsinogen-based gastric cancer screening
Issue Date: 2018
Abstract: BACKGROUND: Even though mass gastric cancer screening is controversial in Western countries, diverse strategies have been proposed in intermediate-risk to high-risk areas. AIM: The aim of this study was to determine the long-term accuracy of the pepsinogen test (PG) for early diagnosis of gastric cancer. PARTICIPANTS AND METHODS: A cohort of inhabitants from the Northern part of Portugal, aged between 40 and 74 years (n=5913), subjected to the PG test (PGI≤70 ng/ml and PGI/PGII≤3), were followed up between November 2006 and December 2015. The diagnosis of gastric cancer was determined through linkage to the population-based registry of cancer [North Region Cancer Registry of Portugal (RORENO)]. RESULTS: Twenty-six gastric cancers were diagnosed (0.4%): nine (4%) among individuals 'positive' for the PG test (n=225) and 15 (0.3%) among those who were 'negative' (n=5688) [hazard ratio=12.7; 95% confidence interval (CI): 5.6-28.6]. Individuals with a 'negative PG test' had a 3-year risk of gastric cancer of 0.1%, representing a sensitivity of 35% (95% CI: 17-56%), globally, and of 58% (95% CI: 28-85%) at 3 years follow-up. The median survival rate in both groups was over 24 months. CONCLUSION: The PG test was found to be suboptimal as a screening test and, if used (before upper gastrointestinal endoscopy), it is mandatory to repeat it after 3 years.
Subject: Gastric cancer - Screening
Series: Eur J Gastroenterol Hepatol. 2018 Mar;30(3):274-277. doi: 10.1097/MEG.0000000000001040.
Document Type: Artigo em Revista Científica Internacional
Rights: restrictedAccess
Appears in Collections:ISPUP - Artigo em Revista Científica Internacional

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