Serum pepsinogens in gastric cancer screening.

摘要

Approximately one million new cases of gastric cancer are expected in 2010 worldwide. This disease is the second most frequent cause of cancer deaths [1]. In most countries, the tumors are detected when the invasion of the muscu-laris propria has taken place and the prognosis is dismal, even after gastrectomy and chemotherapy, with 5-year survival rates around 20% [1]. If the tumors are diagnosed when limited to the mucosa and submucosa, so called "early" cancers, the 5-year survival rate is over 90% [2, 3]. In Japan, extensive screening programs taking advantage of abundant endoscopic resources and superb expertise, including the use of serum pepsinogen (PG) tests, have succeeded in diagnosing the majority of gastric cancers in their early stages [4]. Screening programs have led to an overall 5-year survival rate for gastric cancer in Japan of 40-60% [5]. Such resources are not available in most Western countries.