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Risk of cancers of the oesophagus and stomach by histology or subsite in patients hospitalised for pernicious anaemia.
Gut 2003; 52(7):938-41Gut

Abstract

BACKGROUND

Although pernicious anaemia is an established risk factor for stomach cancer, data by anatomical subsite are not available. Moreover, a previous suggestion of a link to increased risk of oesophageal cancer needs further exploration.

METHODS

We followed 21 265 patients hospitalised for pernicious anaemia in Sweden from 1965 to 1999 for an average of 7.1 years. Standardised incidence ratio (SIR) adjusted for sex, age, and calendar year was used to estimate relative risk, using the Swedish nationwide cancer incidence rates as reference.

RESULTS

Significant excess risks for squamous cell carcinoma of the oesophagus, and stomach cancer distal to the cardia, were observed in pernicious anaemia patients (SIR 3.3 (95% confidence interval (CI) 2.4-4.4); SIR 2.4 (95% CI 2.1-2.7), respectively). The excess risks increased with increasing follow up duration. Among distal stomach cancers, the most conspicuous excess risk was for carcinoid tumours (SIR 26.4 (95% CI 14.8-43.5)). Compared with the general population, no significant increased risk was observed for adenocarcinoma of the oesophagus (SIR 1.7 (95% CI 0.7-3.4)) or gastric cardia (SIR 1.2 (95%CI 0.6-2.0)).

CONCLUSIONS

Achlorhydria following type A atrophic gastritis is associated with an elevated risk of adenocarcinoma of the non-cardia stomach, and surprisingly, with a risk of oesophageal squamous cell carcinoma. In contrast, no significant association, either positive or negative, was found with oesophageal or cardia adenocarcinoma. The mechanism for the observed increased risk of oesophageal squamous cell carcinoma warrants further study.

Authors+Show Affiliations

Department of Medical Epidemiology, Karolinska Institutet, Box 281, SE 171 77 Stockholm, Sweden. Ye@mep.ki.seNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12801947

Citation

Ye, W, and O Nyrén. "Risk of Cancers of the Oesophagus and Stomach By Histology or Subsite in Patients Hospitalised for Pernicious Anaemia." Gut, vol. 52, no. 7, 2003, pp. 938-41.
Ye W, Nyrén O. Risk of cancers of the oesophagus and stomach by histology or subsite in patients hospitalised for pernicious anaemia. Gut. 2003;52(7):938-41.
Ye, W., & Nyrén, O. (2003). Risk of cancers of the oesophagus and stomach by histology or subsite in patients hospitalised for pernicious anaemia. Gut, 52(7), pp. 938-41.
Ye W, Nyrén O. Risk of Cancers of the Oesophagus and Stomach By Histology or Subsite in Patients Hospitalised for Pernicious Anaemia. Gut. 2003;52(7):938-41. PubMed PMID: 12801947.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of cancers of the oesophagus and stomach by histology or subsite in patients hospitalised for pernicious anaemia. AU - Ye,W, AU - Nyrén,O, PY - 2003/6/13/pubmed PY - 2003/8/20/medline PY - 2003/6/13/entrez SP - 938 EP - 41 JF - Gut JO - Gut VL - 52 IS - 7 N2 - BACKGROUND: Although pernicious anaemia is an established risk factor for stomach cancer, data by anatomical subsite are not available. Moreover, a previous suggestion of a link to increased risk of oesophageal cancer needs further exploration. METHODS: We followed 21 265 patients hospitalised for pernicious anaemia in Sweden from 1965 to 1999 for an average of 7.1 years. Standardised incidence ratio (SIR) adjusted for sex, age, and calendar year was used to estimate relative risk, using the Swedish nationwide cancer incidence rates as reference. RESULTS: Significant excess risks for squamous cell carcinoma of the oesophagus, and stomach cancer distal to the cardia, were observed in pernicious anaemia patients (SIR 3.3 (95% confidence interval (CI) 2.4-4.4); SIR 2.4 (95% CI 2.1-2.7), respectively). The excess risks increased with increasing follow up duration. Among distal stomach cancers, the most conspicuous excess risk was for carcinoid tumours (SIR 26.4 (95% CI 14.8-43.5)). Compared with the general population, no significant increased risk was observed for adenocarcinoma of the oesophagus (SIR 1.7 (95% CI 0.7-3.4)) or gastric cardia (SIR 1.2 (95%CI 0.6-2.0)). CONCLUSIONS: Achlorhydria following type A atrophic gastritis is associated with an elevated risk of adenocarcinoma of the non-cardia stomach, and surprisingly, with a risk of oesophageal squamous cell carcinoma. In contrast, no significant association, either positive or negative, was found with oesophageal or cardia adenocarcinoma. The mechanism for the observed increased risk of oesophageal squamous cell carcinoma warrants further study. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/12801947/Risk_of_cancers_of_the_oesophagus_and_stomach_by_histology_or_subsite_in_patients_hospitalised_for_pernicious_anaemia_ L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&pmid=12801947 DB - PRIME DP - Unbound Medicine ER -