Chiang TH, et al. - In this investigation, researchers validated the long-term correlation between initial serum pepsinogen (PG) measurements and subsequent gastric cancer-specific deaths from a long-term longitudinal cohort. In order to determine serum PG levels, 1682 were screened among 3514 participants (aged ≥30 years). Multivariate analyses adjusted for age, sex, and Helicobacter pylori serological positivity displayed that PG-I <30 μg/L and PG-I <30 μg/L or PG-I/II ratio <3 were significantly related to the risk of gastric cancer death. On the other hand, there was no significant association between PG and other death causes, including neoplastic and non-neoplastic diseases. This long-term cohort study exhibited the usefulness of measuring PG as a biomarker specific to the risk of death from gastric cancer.