BACKGROUND: Pancreatic cancer is a highly fatal disease without screening tests. Studies have suggested possible etiologic similarities between gastric and pancreatic cancers. Atrophic gastritis, a pre-malignant condition for gastric cancer, is characterized by low serum pepsinogen I (SPGI) level. We hypothesized that low SPGI level may be associated with an increased risk of pancreatic cancer and be a useful biomarker for the disease. METHODS: Our analytic cohort included 20,962 participants in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC) who had SPGI level measured. Of these, 1663 (7.9%) subjects had low SPGI levels (<25 microg/l) and were invited for gastroscopy which was completed in 1059 (63.7%) participants. Atrophic gastritis was histologically confirmed in 1006 (95.0%) subjects. We used Cox proportional hazards regression to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for pancreatic cancer. RESULTS: During follow-up of up to 16.3 years (mean=10.8 years; 226,325 person-years), 227 incident pancreatic cancers were diagnosed. The incidence rates were 9.9, 11.3, and 12.7 per 10,000 person-years of follow-up for participants with normal pepsinogen level (> or = 25 microg/l), low pepsinogen level and histologically confirmed atrophic gastritis, respectively. Compared to subjects with normal pepsinogen levels, there was no statistically significant increased risk of pancreatic cancer among subjects with low pepsinogen level (adjusted HR=1.01; 95% CI: 0.63-1.62) or those with histologically confirmed atrophic gastritis (adjusted HR=1.13; 95% CI: 0.66-1.95). CONCLUSIONS: Atrophic gastritis, serological or histological, is not associated with increased risk of pancreatic cancer. These findings do not provide any evidence for potential usefulness of SPGI for pancreatic cancer screening.
BACKGROUND:Pancreatic cancer is a highly fatal disease without screening tests. Studies have suggested possible etiologic similarities between gastric and pancreatic cancers. Atrophic gastritis, a pre-malignant condition for gastric cancer, is characterized by low serum pepsinogen I (SPGI) level. We hypothesized that low SPGI level may be associated with an increased risk of pancreatic cancer and be a useful biomarker for the disease. METHODS: Our analytic cohort included 20,962 participants in the Alpha-Tocopherol, Beta-CaroteneCancer Prevention Study (ATBC) who had SPGI level measured. Of these, 1663 (7.9%) subjects had low SPGI levels (<25 microg/l) and were invited for gastroscopy which was completed in 1059 (63.7%) participants. Atrophic gastritis was histologically confirmed in 1006 (95.0%) subjects. We used Cox proportional hazards regression to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for pancreatic cancer. RESULTS: During follow-up of up to 16.3 years (mean=10.8 years; 226,325 person-years), 227 incident pancreatic cancers were diagnosed. The incidence rates were 9.9, 11.3, and 12.7 per 10,000 person-years of follow-up for participants with normal pepsinogen level (> or = 25 microg/l), low pepsinogen level and histologically confirmed atrophic gastritis, respectively. Compared to subjects with normal pepsinogen levels, there was no statistically significant increased risk of pancreatic cancer among subjects with low pepsinogen level (adjusted HR=1.01; 95% CI: 0.63-1.62) or those with histologically confirmed atrophic gastritis (adjusted HR=1.13; 95% CI: 0.66-1.95). CONCLUSIONS:Atrophic gastritis, serological or histological, is not associated with increased risk of pancreatic cancer. These findings do not provide any evidence for potential usefulness of SPGI for pancreatic cancer screening.
Authors: A C Tersmette; G J Offerhaus; F M Giardiello; K W Tersmette; J P Vandenbroucke; G N Tytgat Journal: Int J Cancer Date: 1990-11-15 Impact factor: 7.396
Authors: Michael B Cook; Farin Kamangar; Stephanie J Weinstein; Demetrius Albanes; Jarmo Virtamo; Philip R Taylor; Christian C Abnet; Richard J Wood; Gayle Petty; Amanda J Cross; Sanford M Dawsey Journal: Cancer Epidemiol Biomarkers Prev Date: 2012-09-20 Impact factor: 4.254
Authors: Jiaqi Huang; Ulrika Zagai; Göran Hallmans; Olof Nyrén; Lars Engstrand; Rachael Stolzenberg-Solomon; Eric J Duell; Kim Overvad; Verena A Katzke; Rudolf Kaaks; Mazda Jenab; Jin Young Park; Raul Murillo; Antonia Trichopoulou; Pagona Lagiou; Christina Bamia; Kathryn E Bradbury; Elio Riboli; Dagfinn Aune; Konstantinos K Tsilidis; Gabriel Capellá; Antonio Agudo; Vittorio Krogh; Domenico Palli; Salvatore Panico; Elisabete Weiderpass; Anne Tjønneland; Anja Olsen; Begoña Martínez; Daniel Redondo-Sanchez; Maria-Dolores Chirlaque; Petra Hm Peeters; Sara Regnér; Björn Lindkvist; Alessio Naccarati; Eva Ardanaz; Nerea Larrañaga; Marie-Christine Boutron-Ruault; Vinciane Rebours; Amélie Barré; H B As Bueno-de-Mesquita; Weimin Ye Journal: Int J Cancer Date: 2017-04-15 Impact factor: 7.396