Assessment of Serum Pepsinogens with and without Co-Testing with Gastrin-17 in Gastric Cancer Risk Assessment—Results from the GISTAR Pilot Study

Introduction-Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods-Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results-Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4-31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33-45% while specificity decreased (range: 61.1-62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions-Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage

Young GI Societies in Europe: 2019 update

Abstract Background: One of the aims of the Young Talent Group (YTG) is to make United European Gastroenterology (UEG) more attractive to young fellows interested in gastroenterology (GI), and to actively involve them in UEG activities and the activities of their respective national societies. In 2017, we conducted a survey among the Friends of the UEG YTG with the aim of identifying the state of organization and needs of Young GI Sections (YGISs) throughout Europe, highlighting areas for further development and improvement. Aims: The aim of the current web-based survey was to assess the progress of YGISs over 1 year, and persisting hurdles in forming and running a YGIS. Results: Overall, 38 of 42 Friends answered the survey (91%). The number of YGISs has increased significantly from 12 in 2017 to 25 in 2019. Young gastroenterologists remained supported, but not influenced, by national societies. Results of the survey suggest that a lack of dedicated and motivated fellows has replaced a lack of funding as the most prevalent hurdle in forming these types of sections. Conclusion: Our survey shows that the development of YGISs has improved markedly within the last 2 years. However, several limitations, like underrepresentation in subcommittees of national societies, remain and need to be addressed in order to involve young gastroenterologists in their respective national societies and within UEG, to pave the way for future research, education and excellent quality of care, and reduce health inequalities across Europe