Evidence map›Paper›PMID 35534235›Full record

ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2022

Serum Pepsinogen as a Biomarker for Gastric Cancer in the United States: A Nested Case-Control Study Using the PLCO Cancer Screening Trial Data.

Haejin In, Srawani Sarkar, Jessica Ward, Patricia Friedmann, Michael Parides, Julie Yang, Meira Epplein

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
6.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.

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  3. Screening strategies for the early detection of non-cardia gastric cancer in low- to moderate-prevalence regions: Asia-Pacific gastroesophageal cancer congress consensus 2026.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Haejin InMontefiore Medical Center/Albert Einstein College of Medicine, Department of Surgery, Bronx, New York.ORCID 0000-0003-3267-6585
Srawani SarkarMontefiore Medical Center/Albert Einstein College of Medicine, Department of Surgery, Bronx, New York.
Jessica WardAlbert Einstein College of Medicine, Bronx, New York.
Patricia FriedmannMontefiore Medical Center/Albert Einstein College of Medicine, Department of Surgery, Bronx, New York.
Michael ParidesMontefiore Medical Center/Albert Einstein College of Medicine, Department of Surgery, Bronx, New York.
Julie YangDivision of Gastroenterology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York.
Meira EppleinDepartment of Population Health Sciences, and Cancer Risk, Detection, and Interception Program, Duke Cancer Institute, Duke University, Durham, North Carolina.ORCID 0000-0001-5646-6430
Albert Einstein College of Medicine · USRutgers, The State University of New Jersey · USDuke University · USHospital for Special Surgery · US

Funding

CTSA Administrative Supplement for Informatics Core: A novel AI/ML system to predict respiratory failure and ARDS in Covid-19 patientsUL1TR002556 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI KELLER, MARLA J, KIM, MIMI Y · 2018 to 2022
$26.7M
NCATS NIH HHS UL1 TR002556
6 · The paper itself

Abstract

backgroundGastric cancer lacks specific symptoms, resulting in diagnosis at later stages and high mortality. Serum pepsinogen is a biomarker for atrophic gastritis, a gastric cancer precursor, and may be useful to detect persons at increased risk of gastric cancer.

methodsThe Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial was conducted in the United States between 1993 and 2001. ELISA-based pepsinogen tests were conducted on prediagnostic serum samples of 105 PLCO participants who developed gastric cancer and 209 age, sex, and race-matched controls. Pepsinogen positive (PG+) was defined as pepsinogen I ≤ 70 μg/L and pepsinogen I/II ratio ≤3.0. Results of conditional logistic regression models, and sensitivity and specificity, of PG+ for gastric cancer are reported.

resultsGastric cancer cases were more likely to be PG+ (31.4% vs. 5.5%, P < 0.001) at baseline than controls. Compared to PG-, PG+ was associated with an 8.5-fold increased risk for gastric cancer [95% confidence interval (CI) = 3.8-19.4]. This risk remained significant after adjusting for Helicobacter pylori, family history of gastric cancer, education, smoking, and BMI (aOR, 10.6; 95% CI, 4.3-26.2). In subgroup analysis, PG+ individuals were 11-fold more like to develop non-cardia gastric cancer (OR, 11.1; 95% CI, 4.3-28.8); conversely, they were not significantly more likely to develop cardia gastric cancer (OR, 2.0; 95% CI = 0.3-14.2). PG+ status yielded low sensitivity but high specificity for both noncardia (44.3%; 93.6%) and cardia gastric cancer (5.7%; 97.2%).

conclusionsPrediagnostic serum pepsinogen levels from a large, prospective cohort study were associated with risk of gastric cancer, particularly noncardia gastric cancer. IMPACT: PG status may identify individuals at higher risk of noncardia gastric cancer for targeted screening or interventions. See related commentary by Zhou and Huang, p. 1257.

Indexed as

Pepsinogen APepsinogen CStomach NeoplasmsBiomarkersCase-Control StudiesClinical Trials as TopicEarly Detection of CancerGastritis, AtrophicHelicobacter InfectionsHelicobacter pyloriHumansMaleProspective StudiesProstateUnited StatesBiomarkersPepsinogen APepsinogen C

Identifiers

PMID35534235
PMCPMC9268394
OpenAlexW4229449745

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.