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The risk of pancreatic cancer in patients with gastric or duodenal ulcer disease
- Source :
- International Journal of Cancer. 120:368-372
- Publication Year :
- 2006
- Publisher :
- Wiley, 2006.
-
Abstract
- Although Helicobacter pylori (H. pylori) seropositivity is linked to an excess risk of pancreatic cancer, the biologic mechanism is unknown. Gastric ulcer is primarily associated with corpus colonization of H. pylori, atrophic gastritis and formation of N-nitrosamines. Duodenal ulcer is a marker of antral colonization, hyperacidity and uninhibited secretin release. We estimated relative risks for pancreatic cancer among patients with gastric or duodenal ulcer, based on a register-based retrospective cohort study with 88,338 patients hospitalized for gastric ulcer and 70,516 patients for duodenal ulcer recorded in the Swedish Inpatient Register between 1965 and 2003. Following operation, the 14,887 patients who underwent gastric resection and 8,205 with vagotomy were analyzed separately. Multiple record-linkages allowed complete follow-up and identification of all incident cases of pancreatic cancer until December 31, 2003. Standardized incidence ratios (SIRs) estimated relative risks. During years 3-38 of follow-up, we observed a 20% excess risk (95% confidence interval [CI] 10-40%) for pancreatic cancer among unoperated gastric ulcer patients. The excess increased to 50% (95% CI 10-110%) 15 years after first hospitalization (p for trend = 0.03). SIR was 2.1 (95% CI 1.4-3.1) 20 years after gastric resection. Unoperated duodenal ulcer was not associated with pancreatic cancer risk, nor was vagotomy. Our results lend indirect support to the nitrosamine hypothesis, but not to the hyperacidity hypothesis in the etiology of pancreatic cancer.
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
Pancreatic disease
Atrophic gastritis
medicine.medical_treatment
Vagotomy
Gastroenterology
Helicobacter Infections
Gastrectomy
Risk Factors
Internal medicine
Pancreatic cancer
Humans
Medicine
Stomach Ulcer
Risk factor
Aged
Helicobacter pylori
biology
business.industry
Incidence
Retrospective cohort study
Middle Aged
medicine.disease
biology.organism_classification
digestive system diseases
Pancreatic Neoplasms
Oncology
Duodenal Ulcer
Female
business
Subjects
Details
- ISSN :
- 10970215 and 00207136
- Volume :
- 120
- Database :
- OpenAIRE
- Journal :
- International Journal of Cancer
- Accession number :
- edsair.doi.dedup.....e39e5ca5124bdfd76cfe1d0416f5731f