Gastric Cancer Risk Screening with Pepsinogen Tests for Japanese Expatriates in the Netherlands

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  • Yuri Okabe
    School of Biomedical Science, Tokyo Medical and Dental University Tokyo Skin Clinic Roppongi Avenue Clinic
  • René A. du Cloo
    School of Biomedical Science, Tokyo Medical and Dental University Tokyo Skin Clinic Roppongi Avenue Clinic
  • Hiroshi Tanaka
    School of Biomedical Science, Tokyo Medical and Dental University

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Background Since 2003 we have been using the pepsinogen test method for gastric cancer risk screening in the Health Check for Japanese Residents in the NetherlandsTM. The target group of our screening comprises relatively young and healthy expatriates. On one hand, with a presumably low prevalence of cancerrelated pathology, the percentage of positive test results is considerably low. On the other hand, in the Dutch health care context it is mandatory to adjust the percentage of abnormal results so that referrals to specialists are kept minimal. In this study we explored an additional application of pepsinogen tests to improve the yield of screenings within the limitations.<br>Methods The first-time test data (n=772) obtained from our study population were analysed to describe trends in pepsinogen 1 and 2 levels and ratio in relation to sex and age. The criteria for active gastritis based on pepsinogen levels were then applied to the same data excluding positive test results. The cases thus sorted out were further analyzed.<br>Results Our study population showed similar trends to those found in the literature with regard to differences in pepsinogen levels and ratio between both genders and different age groups. The "active-gastritis" group showed a significantly lower pepsinogen ratio than the remaining group, which presumably represents a late stage of active gastritis in transition to atrophic gastritis.<br>Conclusion An assumed low prevalence of advanced pathology in our study population may justify an extended application of pepsinogen tests based on assessment with pepsinogen levels and ratio for preventing gastric cancer at an early stage. (Ningen Dock 2011; 25: 21-25)

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