Chiang TH, et al. - The long-term association between initial serum pepsinogen (PG) measurements and subsequent gastric cancer-specific deaths from long-term longitudinal cohort was validated by researchers in this analysis. In order to determine serum PG levels, 1682 (47.9%) were screened among participants (n=3514) aged ≥30 years. Fourteen deaths from gastric cancer were documented after 16 years of follow-up. Multivariate analyses adjusted for age, sex, and Helicobacter pylori serological positivity exhibited 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. There were, on the other hand, no significant associations between PG and other death causes, including neoplastic and non-neoplastic diseases. This long-term cohort study demonstrates the usefulness of measuring PG as a biomarker specific to the risk of death from gastric cancer.