Table 2.

Pepsinogen-based studies

Authors, year (ref.*)Study population
Prevalence of pepsinogen defined CAG in %
Criteria for diagnosis
Country (time of survey)SettingNo. participants (gender), response rateAge (mean)Overall (severe)By sex (severe)By age (severe)
Krasinski et al., 1986 (29, 30)USA (1981-1984)Elderly people (recruited via advertising)359 (M, 34.8%; F, 65.2%)60-99 (76 ± 9)31.5 (8.1)60-69: 24.0 (4.8)all: PGI/PGII <2.9 sev: (PGI/PGII <2.9 and PGI <20 ng/ml)
70-79: 31.7 (7.3)
80-99: 37.1 (11.1)
Burr et al., 1987 (31)UKTwo towns with different GC-death rate (GP lists)513 (only men), 75%65-74 (69)(7.7)§ (14.5)§sev: PGI <20 ng/ml
Palli et al., 1991(32)Italy (1985-1989)Population registry based (4 regions)930 (M, 58 %; F, 42 %), 61%35-74 (58.9)12.1 (5.8)M, 13.3 (6.5); F, 10.5 (4.9)35-49: 5.6 (1.3)all: (PGI >20 ng/ml and PGI/PGII ≤2.9) or PGI ≤20 ng/ml sev: PGI ≤20 ng/ml
50-64: 9.9 (4.5)
65-74: 18.6 (10.0)
Fukao et al., 1993 (33, 34)Japan (1991-1992)Blood donors (four regions)1 815 (M, 51.2%; F, 48.8%)13-38M, 13.9-38.8 5; F, 12.3-37.8 5Age: male/femaleall: PGI <70 ng/ml and PGI/PGII <3.0
16-19: 3-13/5-15
20-29: 5-20/0-20
30-39: 10-40/3 -33
40-49: 17-42/12-45
50-59: 22-66/15-62
60-64: 26-62/28-69
Tsugane et al., 1993 (35, 36)Japan (1989-1991)Population registry based (five regions)624 (only men), 60-80%40-499.4-26.6all: PGI <70 ng/ml and PGI/PGII <3.0
Webb et al., 1994 (3739)13 nations (17 populations) (1989-1991)Population registry offices; GP lists; driver's license rosters; health screenings3 195 (M/F, ∼50%/50%)25-34 and 55-64(4.8)M, (4.1); F, (5.5)25-34: (2.1)sev: PGI < 25 ng/ml
55-64: (7.5)
Europe2,410(3.3)M, (2.4); F, (4.2)25-34: (1.3)
55-64: (5.3)
Japan386(6.1)M, (7.5); F, (4.8)25-34: (1.5)
655-64: (10.8)
US198(1.5)M, (1.1); F, (2.0)25-34: (0)
55-64: (3.1)
Algeria200(14.2)M, (10.7); F, (20.0)25-34: (10.4)
655-64: (16.0)
Knight et al., 1995 (40, 41)UKIndustry workers (recruited from four factories)420 (only men)18-63 (40)(3.1)moderate and severe: PGI/PGII <2.5
Schlemper et al., 1995 (42)the Netherlands (1991)Medical examination at workplace498 (M, 85%; F, 15%), 95%22-71 (48)3.6 (1.6)all: PGI/PGII <1.3 sev: PGI < 17 ng/ml
Japan (1988)225 (M, 84%; F, 16%), 99%32.4 (4.4)
Aromaa et al., 1996 (43)Finland (1968-1972)Health screening (controls for cancer cases)146 (M, 63.7%; F, 36.3%), 82.5%≥15 (61)19.9all: PGI <49 ng/ml
Watanabe et al., 1997 (44)Japan (1987)Annual health examination1 290 (M, 34.3%; F, 65.7%)≥3540.4M, 41; F, 40Age: male/femaleall: PGI ≤70 ng/ml and PGI/PGII ≤3.0
35-39: 20/14
40-49: 32/29
50-59: 44/39
60-69: 38/42
Varis et al., 1998 (46)Finland (1985-1988)Smokers (population registry based)29,133 (only men)50-69 (57)(6.0)sev: PGI <25 ng/ml
Van Asselt et al., 1998 (47)the Netherlands (1993)Older adults (“randomly chosen”)105 (M, 44%; F, 56%)74-80 (76)32.4 (12.7)all: PGI/PGII <1.6 sev: PGI/PGII <1.6 and PGI <17 ng/ml
Tsugane et al., 1999 (48)Japanese in Brazil (1989)Population registry based168 (M, 48%; F, 52%), 64%40-5939.3 (25.0)M, 33.3 (22.2); F, 44.8 (27.6)40-49: 31.9 (26.6)all: PGI <70 ng/ml and PGI/PGII <3.0 sev: PGI <30 ng/ml
50-59: 48.7 (23.0)
18.2 (9.1)M, 16.7 (16.7); F, 19.1 (4.4)40-49: 11.4 (9.1)
Japanese in Peru (1995)110 (M, 38%; F, 62%), 80%50-59: 22.7 (9.1)
Kuwahara et al., 2000 (49)Japan(1993-1994)Self-defense forces (pre-retirement examination)566 (only men)50-5535.7 (17.1)all: PGI <70 ng/ml and PGI/PGII <3.0 sev: PGI <70 ng/ml and PGI/P GII <2.0
Namekata et al., 2000 (50)Japanese in USA (1994)CVD-screening776 (M, 53.5 %; F, 46.5 %)20-86M, 14.5; F, 11.9Age: male/femaleall: PGI <70 ng/ml and PGI/PGII <3.0
50: 3/2
50-64: 15/16
65-74: 28/20
75-82: 35/37
Shibata et al., 2000 (51)Japan (1997)Health screening636 (M, 39%; F, 61%), 71%30-6434.1M, 33.5; F, 34.5age: male/femaleall: PGI <70 ng/ml and PGI/PGII <3.0
30-34: 8/11
35-39: 12/23
40-44: 22/25
45-49: 31/27
50-54: 39/32
55-59: 33/39
60-64: 51/49
Ito et al., 2000 (52)Japan (1997)Health checkup210 (M, 38%; F, 62%)40 to ≥7044M, 46.3; F, 44.6Age: male/femaleall: PGI ≤70 ng/ml and PGI/PGII ≤3.0
40-49: 36.8/44.2
50-59: 43.5/55.6
60-69: 50.0/31.4
≥70: 41.7/42.9
Shibata et al., 2002 (53)Japan (1993)Health screening954 (M, 33%; F, 67%), 47%30-7926.6M, 30.1; F, 24.9Age: male/femaleall: PGI <70 ng/ml and PGI/PGII <3.0
30-39: 0/7
40-49: 13/19
50-59: 26/21
60-69: 37/28
70-79: 38/45
Sipponen et al., 2003 (54)Finland (1994-1996)Population registry based12,252 (only men)51-65(5.2)sev: PGI <25 ng/ml
Kobayashi et al., 2004 (55)Japan (1989)Health checkup4,48620-59Age: male/femaleall: PGI ≤70 ng/ml and PGI/PGII ≤3.0
20-29: 9/11
30-39: 20/23
40-49: 30/51
50-59: 45/38
Japan (1996)4,506Age: male/female
20-29: 3/3
30-39: 5/5
40-49: 12/14
50-59: 25/27
Ohata et al., 2004 (56)Japan (1994-1995)Annual health checkup4,655 (only men)40-59 (50)28.9all: PGI <70 ng/ml and PGI/PGII <3.0
Sato et al., 2004 (57)Japan (1997)Annual health checkup438 (only men)39-60 (48)19.6all: PGI ≤70 ng/ml and PGI/PGII ≤3.0
Kikuchi et al., 2005 (58)Japan (1988-1990)Controls for cancer cases (health checkup based)633 (M, 55%; F, 45%)40 to ≥7060 (29)M, 61 (31); F, 58 (27)Age: male/femaleall: (PGI <70 ng/ml and PGI/PGII <3.0) or (PGI <50 ng/ml and PGI/PGII <2.0) sev: PGI < 50 ng/ml and PGI/PGII < 2.0
40-49: 41 (12)/38 (10)
50-59: 61 (27)/57 (27)
60-69: 61 (30)/60 (28)
≥70: 64 (39)/67 (39)
Green et al., 2005 (59)New Zealand (1997)Population registry based466 (M, 49%; F, 51%), 53%≥656.7 (3.1)all: PGI/PGII ≤2.9 sev: PGI/PGII ≤2.9 and PGI <20 ng/ml
Aoki et al., 2005 (60)
Japan (1991)Health checkup859 (M, 37%; F, 63%)20-87 (60)Age: male/femaleall: PGI ≤70 ng/ml and PGI/PGII ≤3.0
29: 8/18
30-39: 21/41
40-49: 41/43
50-59: 50/47
60-69: 61/55
≥70: 58/59
China (1996-1997)Health survey1 741 (M, 37%; F, 63%)17-85 (43)age: male/female
29: 5/9
30-39: 11/10
40-49: 11/7
50-59: 17/11
60-69: 19/18
≥70: 29/19
Tanzania (2001)All inhabitants of four villages573 (M, 43%; F, 57%), 100%7-90 (24)Age: male/female
29: 29/32
30-39: 21/35
40-49: 24/37
50-59: 11/56
60-69: 39/47
≥70: 27/41
Dominican Republic (2001-2002)All inhabitants of randomly selected communities1,215 (M, 37%; F, 63%), 100%14-92 (33)Age: male/female
29: 13/13
30-39: 14/23
40-49: 33/31
50-59: 24/29
60-69: 25/26
≥70: 37/21
  • Abbreviations: all, mild, moderate, and severe forms of CAG; CVD, cardiovascular disease; F, female; GC, gastric cancer; GP, general practitioner; Hp-gastritis, H. pylori–induced gastritis; M, male; sev, severe form of CAG.

  • * When multiple references are listed: the first publication contains data on prevalence rates, the others contain information on additional extracted study details.

  • Median (instead of mean) in Knight et al. (40), Varis et al. (46), van Asselt et al. (47) and Aoki et al. (60).

  • Age-stratified data were derived from graphs in Fukao et al. (33), Kobayashi et al. (55) and Aoki et al. (60).

  • § The two different prevalence rates refer to the two examined towns with different stomach cancer death-rates.

  • Variations refer to different regions (the overall values are age adjusted for the different regions).

  • Prevalences in the different populations are alphabetically listed in detail in the following [with the following structure: country (city): young males/young females/old males/old females]: Algeria (Algiers): 4.4/20.4/12.5/19.6; Belgium (Ghent): 0/1.9/0/3.9; Denmark (Copenhagen): 0/2.7/2.9/2.9; Germany (Augsburg): 0/0/5.6/8.5; Germany (Deggendorf): 0/1.7/4.4/4.4; Germany (Mosbach): 0/0/2.5/4.6; Greece (Crete): 0/0/8.3/9.8; Iceland (S Region): 2.1/3.9/3.9/5.8; Italy (Florence): 2.2/0/5.6/3.7; Japan (Miyagi): 0/0/17.8/4.8; Japan (Yokote): 2.0/4.0/10.2/10.2; Poland (Adamowka): 0/4.6/5.3/12.5; Portugal (Gaia): 0/3.3/5.4/9.7; Solovenia (Ljublijana): 0/6.1/6.3/10.0; United Kingdom (Oxford): 0/0/2.4/8.3; United Kingdom (Stoke): 2.1/3.9/4.1/5.9; United States (Minneapolis-St. Paul): 0/0/2.1/4.0.