Relation between gastric cancer and previous peptic ulcer disease.

Abstract:

BACKGROUND:It is presently not well understood to what extent peptic ulcer and gastric cancer represent related diseases. AIMS:The objective of this study was to assess past occurrence of gastric and duodenal ulcers in patients with cancer of the gastric cardia or other parts of the stomach. METHODS:The association between peptic ulcer and gastric cancer was studied among patients followed up at hospitals of the US Department of Veterans Affairs. Two populations of 1069 subjects with cancer of the cardia and 3078 subjects with cancer of other parts of the stomach were compared with a control population of 89082 subjects without gastric cancer. In multivariate logistic regressions, presence or absence of cancer served as the outcome variable, while age, sex, race, previous histories of gastric ulcer, duodenal ulcer, peptic ulcer site unspecified, gastric resection, or vagotomy served as modifier variables. RESULTS:Old age, non-white ethnicity, and male sex proved strong and independent risk factors for non-cardiac gastric cancer. A previous history of gastric, but not duodenal ulcer was associated with a significantly raised odd ratio of 1.53 (95% confidence interval: 1.24 to 1.87). Cancer of the cardia affected predominantly whites, and was relatively more common in men than non-cardiac gastric cancer. Past gastric ulcers exerted no significant influence (1.02, 0.67 to 1.56), while duodenal ulcers and peptic ulcer site unspecified were protective (duodenal ulcer: 0.68, 0.47 to 0.95; peptic ulcer disease: 0.66, 0.47 to 1.00). Partial gastrectomy was a risk factor for non-cardiac gastric cancer (1.86, 1.32 to 2.63), but not for cancer of the cardia (1.09, 0.54 to 2.20). CONCLUSION:These epidemiological patterns might stem from underlying differences in the influences of gastritis and acid secretion on the development of the two cancer types.

journal_name

Gut

journal_title

Gut

authors

Molloy RM,Sonnenberg A

doi

10.1136/gut.40.2.247

subject

Has Abstract

pub_date

1997-02-01 00:00:00

pages

247-52

issue

2

eissn

0017-5749

issn

1468-3288

journal_volume

40

pub_type

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