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Systematic review: gastric cancer incidence in pernicious anaemia.
Aliment Pharmacol Ther 2013; 37(4):375-82AP

Abstract

BACKGROUND

Pernicious anaemia (PA) has an increased risk for gastric cancer (GC). It is not established whether PA patients need to undergo endoscopic/histological follow-up.

AIM

To provide a systematic overview of the literature on PA and the development of gastric cancer, to estimate the gastric cancer incidence-rate.

METHODS

According to PRISMA, we identified studies on PA patients reporting the incidence of gastric cancer. Quality of studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Meta-analysis on annual gastric cancer incidence rates was performed.

RESULTS

Twenty-seven studies met eligibility criteria. 7 studies were of high, 6 of medium, 10 of low and 4 of very low quality. Gastric cancer incidence-rates ranged from 0% to 0.2% per person-years in 7 American, from 0% to 0.5% in 2 Asiatic, from 0% to 1.2% in 11 Northern European studies and from 0% to 0.9% in 7 studies from other European countries. The incidence-rates of gastric cancer ranged from 0% to 1.2% per person-years in studies which used gastroscopy, from 0.1% to 0.9% in those based on International Classification of Disease. Heterogeneity between studies was not statistically significant at the 5% level (Chi-squared test = 17.9, P = 0.08). The calculated pooled gastric cancer incidence-rate was 0.27% per person-years. Meta-analysis showed overall gastric cancer relative risk in PA as 6.8 (95% CI: 2.6-18.1).

CONCLUSIONS

This systematic review shows a pooled gastric cancer incidence-rate in pernicious anaemia of 0.27% per person-years and an estimated nearly sevenfold relative risk of gastric cancer in pernicious anaemia patients. Further high quality studies are needed to confirm this higher risk.

Authors+Show Affiliations

Dipartimento Medico-Chirurgico di Scienze Cliniche, Tecnobiomediche e Medicina Traslazionale, Sant'Andrea Hospital, School of Medicine, University Sapienza, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23216458

Citation

Vannella, L, et al. "Systematic Review: Gastric Cancer Incidence in Pernicious Anaemia." Alimentary Pharmacology & Therapeutics, vol. 37, no. 4, 2013, pp. 375-82.
Vannella L, Lahner E, Osborn J, et al. Systematic review: gastric cancer incidence in pernicious anaemia. Aliment Pharmacol Ther. 2013;37(4):375-82.
Vannella, L., Lahner, E., Osborn, J., & Annibale, B. (2013). Systematic review: gastric cancer incidence in pernicious anaemia. Alimentary Pharmacology & Therapeutics, 37(4), pp. 375-82. doi:10.1111/apt.12177.
Vannella L, et al. Systematic Review: Gastric Cancer Incidence in Pernicious Anaemia. Aliment Pharmacol Ther. 2013;37(4):375-82. PubMed PMID: 23216458.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review: gastric cancer incidence in pernicious anaemia. AU - Vannella,L, AU - Lahner,E, AU - Osborn,J, AU - Annibale,B, Y1 - 2012/12/10/ PY - 2012/07/26/received PY - 2012/08/21/revised PY - 2012/11/15/revised PY - 2012/11/16/accepted PY - 2012/12/11/entrez PY - 2012/12/12/pubmed PY - 2013/6/28/medline SP - 375 EP - 82 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 37 IS - 4 N2 - BACKGROUND: Pernicious anaemia (PA) has an increased risk for gastric cancer (GC). It is not established whether PA patients need to undergo endoscopic/histological follow-up. AIM: To provide a systematic overview of the literature on PA and the development of gastric cancer, to estimate the gastric cancer incidence-rate. METHODS: According to PRISMA, we identified studies on PA patients reporting the incidence of gastric cancer. Quality of studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Meta-analysis on annual gastric cancer incidence rates was performed. RESULTS: Twenty-seven studies met eligibility criteria. 7 studies were of high, 6 of medium, 10 of low and 4 of very low quality. Gastric cancer incidence-rates ranged from 0% to 0.2% per person-years in 7 American, from 0% to 0.5% in 2 Asiatic, from 0% to 1.2% in 11 Northern European studies and from 0% to 0.9% in 7 studies from other European countries. The incidence-rates of gastric cancer ranged from 0% to 1.2% per person-years in studies which used gastroscopy, from 0.1% to 0.9% in those based on International Classification of Disease. Heterogeneity between studies was not statistically significant at the 5% level (Chi-squared test = 17.9, P = 0.08). The calculated pooled gastric cancer incidence-rate was 0.27% per person-years. Meta-analysis showed overall gastric cancer relative risk in PA as 6.8 (95% CI: 2.6-18.1). CONCLUSIONS: This systematic review shows a pooled gastric cancer incidence-rate in pernicious anaemia of 0.27% per person-years and an estimated nearly sevenfold relative risk of gastric cancer in pernicious anaemia patients. Further high quality studies are needed to confirm this higher risk. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/23216458/Systematic_review:_gastric_cancer_incidence_in_pernicious_anaemia_ L2 - https://doi.org/10.1111/apt.12177 DB - PRIME DP - Unbound Medicine ER -