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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1992 Feb;46(1):12–14. doi: 10.1136/jech.46.1.12

Partial gastrectomy and subsequent gastric cancer risk.

C La Vecchia 1, E Negri 1, B D'Avanzo 1, H Moller 1, S Franceschi 1
PMCID: PMC1059486  PMID: 1573353

Abstract

STUDY OBJECTIVE--The aim was to analyse the relationship between partial gastrectomy and gastric cancer risk. DESIGN--This was a case control study, using a structured questionnaire to obtain problem orientated medical history and sociodemographic data. SETTING--The study was conducted in a network of hospitals in the Greater Milan area between January 1985 and February 1990. SUBJECTS--Subjects were 563 incident cases of histologically confirmed gastric carcinoma (347 males, 216 females, median age 60 years, range 28 to 74) and 1501 controls (885 males, 626 females, median age 58 years, range 23 to 74) in hospital for acute, non-neoplastic, non-digestive-tract disorders. Less than 3% of cases or controls refused to be interviewed. MEASUREMENTS AND MAIN RESULTS--Relative risks (RR) and the corresponding 95% confidence intervals (CI) were determined, adjusted for age and sex plus area of residence, education, and smoking when specified. Within 20 years after gastrectomy, the relative risk of gastric cancer was not significantly raised (RR = 1.2, 95% CI 0.5-2.8), but a positive association emerged after longer time intervals. The RR was 1.6 (95% CI 0.7-4.1) after 20 to 29 years, and 3.5 (95% CI 1.3-10.0) after 30 years or more. These results were consistent in the two sexes and in the subsequent age groups, and not materially influenced by allowance for a number of identified potential confounding factors using multivariate analysis. CONCLUSIONS--The risk of gastric cancer is increased in the long term (20 years or more) after gastrectomy. This is explainable in terms of increased intragastric carcinogen formation following gastrectomy, and/or potential similarities in aetiological correlates of gastric ulcer and carcinoma of the stomach.

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Selected References

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  1. Arnthorsson G., Tulinius H., Egilsson V., Sigvaldason H., Magnusson B., Thorarinsson H. Gastric cancer after gastrectomy. Int J Cancer. 1988 Sep 15;42(3):365–367. doi: 10.1002/ijc.2910420310. [DOI] [PubMed] [Google Scholar]
  2. Breslow N. E., Day N. E. Statistical methods in cancer research. Volume I - The analysis of case-control studies. IARC Sci Publ. 1980;(32):5–338. [PubMed] [Google Scholar]
  3. Caygill C. P., Hill M. J., Kirkham J. S., Northfield T. C. Mortality from gastric cancer following gastric surgery for peptic ulcer. Lancet. 1986 Apr 26;1(8487):929–931. doi: 10.1016/s0140-6736(86)91041-x. [DOI] [PubMed] [Google Scholar]
  4. Colin-Jones D. G., Langman M. J., Lawson D. H., Vessey M. P. Postmarketing surveillance of the safety of cimetidine: 12 month mortality report. Br Med J (Clin Res Ed) 1983 May 28;286(6379):1713–1716. doi: 10.1136/bmj.286.6379.1713. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Jones S. M., Davies P. W., Savage A. Gastric-juice nitrite and gastric cancer. Lancet. 1978 Jun 24;1(8078):1355–1355. doi: 10.1016/s0140-6736(78)92421-2. [DOI] [PubMed] [Google Scholar]
  6. Keighley M. R., Youngs D., Poxon V., Morris D., Muscroft T. J., Burdon D. W., Barnard J., Bavin P. M., Brimblecombe R. W., Darkin D. W. Intragastric N-nitrosation is unlikely to be responsible for gastric carcinoma developing after operations for duodenal ulcer. Gut. 1984 Mar;25(3):238–245. doi: 10.1136/gut.25.3.238. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Kelly J. P., Rosenberg L., Kaufman D. W., Shapiro S. Reliability of personal interview data in a hospital-based case-control study. Am J Epidemiol. 1990 Jan;131(1):79–90. doi: 10.1093/oxfordjournals.aje.a115488. [DOI] [PubMed] [Google Scholar]
  8. La Vecchia C., Negri E., D'Avanzo B., Franceschi S. Histamine-2-receptor antagonists and gastric cancer risk. Lancet. 1990 Aug 11;336(8711):355–357. doi: 10.1016/0140-6736(90)91888-h. [DOI] [PubMed] [Google Scholar]
  9. La Vecchia C., Negri E., Decarli A., D'Avanzo B., Franceschi S. A case-control study of diet and gastric cancer in northern Italy. Int J Cancer. 1987 Oct 15;40(4):484–489. doi: 10.1002/ijc.2910400409. [DOI] [PubMed] [Google Scholar]
  10. Møller H., Lindvig K., Klefter R., Mosbech J., Møller Jensen O. Cancer occurrence in a cohort of patients treated with cimetidine. Gut. 1989 Nov;30(11):1558–1562. doi: 10.1136/gut.30.11.1558. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Reed P. I., Smith P. L., Haines K., House F. R., Walters C. L. Gastric juice N-nitrosamines in health and gastroduodenal disease. Lancet. 1981 Sep 12;2(8246):550–552. doi: 10.1016/s0140-6736(81)90939-9. [DOI] [PubMed] [Google Scholar]
  12. Ross A. H., Smith M. A., Anderson J. R., Small W. P. Late mortality after surgery for peptic ulcer. N Engl J Med. 1982 Aug 26;307(9):519–522. doi: 10.1056/NEJM198208263070902. [DOI] [PubMed] [Google Scholar]
  13. Sandler R. S., Johnson M. D., Holland K. L. Risk of stomach cancer after gastric surgery for benign conditions. A case-control study. Dig Dis Sci. 1984 Aug;29(8):703–708. doi: 10.1007/BF01312941. [DOI] [PubMed] [Google Scholar]
  14. Schumacher M. C., Jick S. S., Jick H., Feld A. D. Cimetidine use and gastric cancer. Epidemiology. 1990 May;1(3):251–254. doi: 10.1097/00001648-199005000-00012. [DOI] [PubMed] [Google Scholar]
  15. Stalsberg H., Taksdal S. Stomach cancer following gastric surgery for benign conditions. Lancet. 1971 Nov 27;2(7735):1175–1177. doi: 10.1016/s0140-6736(71)90489-2. [DOI] [PubMed] [Google Scholar]
  16. Tokudome S., Kono S., Ikeda M., Kuratsune M., Sano C., Inokuchi K., Kodama Y., Ichimiya H., Nakayama F., Kaibara N. A prospective study on primary gastric stump cancer following partial gastrectomy for benign gastroduodenal diseases. Cancer Res. 1984 May;44(5):2208–2212. [PubMed] [Google Scholar]
  17. Viste A., Bjørnestad E., Opheim P., Skarstein A., Thunold J., Hartveit F., Eide G. E., Eide T. J., Søreide O. Risk of carcinoma following gastric operations for benign disease. A historical cohort study of 3470 patients. Lancet. 1986 Aug 30;2(8505):502–505. doi: 10.1016/s0140-6736(86)90368-5. [DOI] [PubMed] [Google Scholar]
  18. Watt P. C., Sloan J. M., Donaldson J. D., Patterson C. C., Kennedy T. L. Relationship between histology and gastric juice pH and nitrite in the stomach after operation for duodenal ulcer. Gut. 1984 Mar;25(3):246–252. doi: 10.1136/gut.25.3.246. [DOI] [PMC free article] [PubMed] [Google Scholar]

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