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Pernicious anemia and subsequent cancer. A population-based cohort study.

Abstract

BACKGROUND

Elevated risk of cancers of the stomach, colon, and buccal cavity, as well as of lymphoma and leukemia, have been reported for patients with pernicious anemia in case reports and hospital-based and cross-sectional studies.

METHODS

A cohort of 2021 men and 2496 women living in the Uppsala health care region in Sweden, discharged with a hospital diagnosis of pernicious anemia from 1965 to 1983, was followed for 20 years for subsequent risk of cancer.

RESULTS

A total of 553 cancers were diagnosed among these patients, significantly more than expected based on cancer standardized incidence rates (SIRs) in the general population (SIR = 1.4; 95% confidence interval [CI], 1.2-1.5). Most prominent were excesses for cancer of the stomach (SIR = 2.9; 95% CI, 2.4-3.5), esophagus (SIR = 3.2; 95% CI, 1.8-5.2), and pancreas (SIR = 1.7; 95% CI, 1.2-2.4) among men and women; myeloid leukemia among men (SIR = 4.4; 95% CI, 1.8-5.2); and multiple myeloma among women (SIR = 2.5; 95% CI, 1.1-4.9). An excess of gastric carcinoid tumors also was evident in this cohort. The risk of stomach cancer was highest in the first year after diagnosis of pernicious anemia (SIR = 7.4; 95% CI, 5.3-10.1), but an increased risk persisted throughout the follow-up period. The risk of esophageal cancer also remained elevated throughout the study period, although the risk of pancreatic cancer dropped off after 5 years.

CONCLUSIONS

This study confirms the excess risk of gastric carcinoma and carcinoid tumors associated with pernicious anemia, and suggests that the susceptibility state may extend to esophageal and other cancers.

Links

Authors+Show Affiliations

,

Division of Cancer Etiology, National Cancer Institute, Bethesda, Maryland 20892.

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Source

Cancer 71:3 1993 Feb 01 pg 745-50

MeSH

Aged
Anemia, Pernicious
Cohort Studies
Esophageal Neoplasms
Female
Humans
Incidence
Male
Neoplasms
Prospective Studies
Risk Factors
Stomach Neoplasms
Sweden

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8431855

Citation

Hsing, A W., et al. "Pernicious Anemia and Subsequent Cancer. a Population-based Cohort Study." Cancer, vol. 71, no. 3, 1993, pp. 745-50.
Hsing AW, Hansson LE, McLaughlin JK, et al. Pernicious anemia and subsequent cancer. A population-based cohort study. Cancer. 1993;71(3):745-50.
Hsing, A. W., Hansson, L. E., McLaughlin, J. K., Nyren, O., Blot, W. J., Ekbom, A., & Fraumeni, J. F. (1993). Pernicious anemia and subsequent cancer. A population-based cohort study. Cancer, 71(3), pp. 745-50.
Hsing AW, et al. Pernicious Anemia and Subsequent Cancer. a Population-based Cohort Study. Cancer. 1993 Feb 1;71(3):745-50. PubMed PMID: 8431855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pernicious anemia and subsequent cancer. A population-based cohort study. AU - Hsing,A W, AU - Hansson,L E, AU - McLaughlin,J K, AU - Nyren,O, AU - Blot,W J, AU - Ekbom,A, AU - Fraumeni,J F,Jr PY - 1993/2/1/pubmed PY - 2001/3/28/medline PY - 1993/2/1/entrez SP - 745 EP - 50 JF - Cancer JO - Cancer VL - 71 IS - 3 N2 - BACKGROUND: Elevated risk of cancers of the stomach, colon, and buccal cavity, as well as of lymphoma and leukemia, have been reported for patients with pernicious anemia in case reports and hospital-based and cross-sectional studies. METHODS: A cohort of 2021 men and 2496 women living in the Uppsala health care region in Sweden, discharged with a hospital diagnosis of pernicious anemia from 1965 to 1983, was followed for 20 years for subsequent risk of cancer. RESULTS: A total of 553 cancers were diagnosed among these patients, significantly more than expected based on cancer standardized incidence rates (SIRs) in the general population (SIR = 1.4; 95% confidence interval [CI], 1.2-1.5). Most prominent were excesses for cancer of the stomach (SIR = 2.9; 95% CI, 2.4-3.5), esophagus (SIR = 3.2; 95% CI, 1.8-5.2), and pancreas (SIR = 1.7; 95% CI, 1.2-2.4) among men and women; myeloid leukemia among men (SIR = 4.4; 95% CI, 1.8-5.2); and multiple myeloma among women (SIR = 2.5; 95% CI, 1.1-4.9). An excess of gastric carcinoid tumors also was evident in this cohort. The risk of stomach cancer was highest in the first year after diagnosis of pernicious anemia (SIR = 7.4; 95% CI, 5.3-10.1), but an increased risk persisted throughout the follow-up period. The risk of esophageal cancer also remained elevated throughout the study period, although the risk of pancreatic cancer dropped off after 5 years. CONCLUSIONS: This study confirms the excess risk of gastric carcinoma and carcinoid tumors associated with pernicious anemia, and suggests that the susceptibility state may extend to esophageal and other cancers. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/8431855/Pernicious_anemia_and_subsequent_cancer__A_population_based_cohort_study_ L2 - http://www.diseaseinfosearch.org/result/441 DB - PRIME DP - Unbound Medicine ER -