Skip to main content
PMC home page
Japanese Journal of Cancer Research : Gann logoLink to Japanese Journal of Cancer Research : Gann
. 1992 Nov;83(11):1137–1142. doi: 10.1111/j.1349-7006.1992.tb02736.x

A Prospective Study of Atrophic Gastritis and Stomach Cancer Risk

Ikuko Kato 1, Suketami Tominaga 2, Yoshiaki Ito 3, Seibi Kobayashi 3, Yuri Yoshii 3, Akira Matsuura 3, Akira Kameya 3, Tomoyuki Kano 3, Akira Ikari 4
PMCID: PMC5918704  PMID: 1483928

Abstract

The relation of atrophic gastritis, other gastric lesions and lifestyle factors to stomach cancer risk was prospectively studied among 3,914 subjects who underwent gastroscopic examination and responded to a questionnaire survey at the Aichi Cancer Center Hospital. During 4.4 years of follow‐up on average, 45 incident cases of stomach cancer were identified at least three months after the initial examination. If the baseline endoscopic findings indicated the presence of atrophic gastritis, the risk of developing stomach cancer was increased 5.73‐fold, compared with no indication at the baseline. The risk further increased with advancing degree of atrophy and increasing extension of atrophy on the lesser curvature. These trends in the relative risks were statistically significant (P= 0.027 and P= 0.041, respectively). The risk of developing stomach cancer was statistically significantly increased among subjects with gastric polyps, but not among those with gastric ulcer. Stomach cancer cases tended to consume more cigarettes, alcohol, rice, pickles and salted fish gut/cod roe and less fruits and vegetables and to have more family histories of stomach cancer than noncases, although these differences were not statistically significant. The results of the present study provide additional evidence on the relation between atrophic gastritis and stomach cancer and suggest a need for intensive follow‐up of patients with atrophic gastritis and gastric polyps.

Keywords: Atrophic gastritis, Gastric polyp, Stomach cancer, Prospective study

Full Text

The Full Text of this article is available as a PDF (364.4 KB).

REFERENCES

  • 1. ) Muir , C. , Waterhouse , J. , Mack , T. , Powell , J. and Whelan , S. “ Cancer Incidence in Five Continents. Vol. V ,” IARC Scientific Publication No. 88 ( 1987. ). IARC; , Lyon . [Google Scholar]
  • 2. ) Kurihara , M. , Aoki , K. and Hisamichi , S. “ Cancer Mortality Statistics in the World 1950–1985 ” ( 1989. ). The University of Nagoya Press; , Nagoya . [Google Scholar]
  • 3. ) Howson , C. P. , Hiyama , T. and Wynder , E. L.The decline in gastric cancer: epidemiology of an unplanned triumph . Epidemiol. Rev. , 8 , 1 – 27 ( 1986. ). [DOI] [PubMed] [Google Scholar]
  • 4. ) Nomura , A.Stomach . In “ Cancer Epidemiology and Prevention ,” ed. Shottenfeld D. and Fraumeni J. F., Jr. , pp. 624 – 637 ( 1982. ), W. B. Saunders; , Philadelphia . [Google Scholar]
  • 5. ) Correa , P. , Cuello , C. and Duque , E.Carcinoma and intestinal metaplasia of the stomach in Colombian migrants . J. Natl. Cancer Inst. , 44 , 297 – 306 ( 1970. ). [PubMed] [Google Scholar]
  • 6. ) Bonne , C. , Hartz , Ph. H. , Klerks , J. V. , Posthuma , J. H. , Radsma , W. and Tjokronegoro , S.Morphology of the stomach and gastric secretion in Malays and Chinese and the different incidence of gastric ulcer and cancer in these races . Am. J. Cancer , 33 , 265 – 279 ( 1938. ). [Google Scholar]
  • 7. ) Imai , T. , Kubo , T. and Watanabe , H.Chronic gastritis in Japanese with reference to high incidence of gastric carcinoma . J. Natl. Cancer Inst , 47 , 179 – 195 ( 1971. ). [PubMed] [Google Scholar]
  • 8. ) Cheli , R. , Simon , L. , Aste , H. , Figus , I. A. , Nicold , G. , Bajtai , A. and Puntoni , R.Atrophic gastritis and intestinal metaplasia in asymptomatic Hungarian and Italian populations . Endoscopy , 12 , 105 – 108 ( 1980. ). [DOI] [PubMed] [Google Scholar]
  • 9. ) Jarvi , O. and Lauren , P.On the role of heterotopias of the intestinal epithelium in the pathogenesis of gastric cancer . Acta Pathol. Microbiol Scand. , 29 , 26 – 43 ( 1951. ). [PubMed] [Google Scholar]
  • 10. ) Morson , B. C.Carcinoma arising from areas of intestinal metaplasia in the gastric mucosa . Br. J. Cancer , 9 , 377 – 385 ( 1955. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11. ) Ming , S. C. , Goldman , H. and Freiman , D. G.Intestinal metaplasia and histogenesis of carcinoma in human stomach . Cancer , 20 , 1414 – 1429 ( 1967. ). [DOI] [PubMed] [Google Scholar]
  • 12. ) Kato , I. , Tominaga , S. , Ito , Y. , Kobayashi , S. , Yoshii , Y. , Matsuura , A. , Kameya , A. and Kano , T.Atrophic gastritis and stomach cancer risk: cross‐sectional analyses . Jpn. J. Cancer Res. , 83 , 1041 – 1046 ( 1992. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13. ) Kato , I. , Tominaga , S. , Ito , Y. , Kobayashi , S. , Yoshii , Y. , Matsuura , A. , Kameya , A. and Kano , T.A comparative case‐control analysis of stomach cancer and atrophic gastritis . Cancer Res. , 50 , 6559 – 6564 ( 1990. ). [PubMed] [Google Scholar]
  • 14. ) Kasugai , T. , Yokoyama , S. , Shiraishi , S. and Takase , T.Age‐distribution of gastric diseases, with special reference to findings of gastric endoscopy and biopsy . Ronenbyo , 7 , 100 – 113 ( 1963. ) ( in Japanese ). [Google Scholar]
  • 15. ) Cox , D. R.Regression models and life tables (with discussion) . J. R. Stat. Soc. Appl. Stat. Sect. B , 34 , 187 – 220 ( 1972. ). [Google Scholar]
  • 16. ) Siurala , M. and Vuorinen , Y.Follow‐up studies of patients with superficial gastritis and patients with a normal gastric mucosa . Acta Med. Scand. , 173 , 45 – 52 ( 1963. ). [DOI] [PubMed] [Google Scholar]
  • 17. ) Munoz , N. and Matko , I.Histological types of gastric cancer and its relationship with intestinal metaplasia . Recent Results Cancer Res. , 39 , 99 – 105 ( 1972. ). [PubMed] [Google Scholar]
  • 18. ) Cheli , R. , Ciancamerla , S. G. and Canciani , G. A.Clinical and statistical follow‐up study of atrophic gastritis . Am. J. Dig. Dis. , 18 , 1061 – 1065 ( 1973. ). [DOI] [PubMed] [Google Scholar]
  • 19. ) Edwards , F. C. and Conghill , N. F.Aetiological factors in chronic atrophic gastritis . Br. Med. J. , 2 , 1049 – 1415 ( 1966. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20. ) Nomura , A. , Yamakawa , H. , Ishidate , T. , Kamiyama , S. , Masuda , H. , Stemmermann , G. N. , Heilbrun , L. K. and Hankin , J. H.Intestinal metaplasia in Japan: association with diet . J. Natl. Cancer Inst. , 68 , 401 – 405 ( 1982. ). [PubMed] [Google Scholar]
  • 21. ) Stemmermann , G. N. , Nomura , A. M. Y. , Chyou , P.‐H. and Hankin , J.Impact of diet and smoking on risk of developing intestinal metaplasia of the stomach. Dig . Dis. Sci , 35 , 433 – 438 ( 1990. ). [DOI] [PubMed] [Google Scholar]
  • 22. ) Kawai , K. , Watanabe , Y. , Hayashi , K. and Mitsuzaki , F.A multi‐disciplinary study on stomach cancer: including intestinal metaplasia as a precancerous lesion . Gendai-Igaku , 34 , 385 – 391 ( 1987. ) ( in Japanese ). [Google Scholar]
  • 23. ) Haenszel , W. , Correa , P. , Cuello , C. , Guzman , N. , Burbano , L. C. , Lores , H. and Munoz , J.Gastric cancer in Colombia. II. case‐control epidemiologic study of precursor lesions . J. Natl. Cancer Inst. , 57 , 1021 – 1026 ( 1976. ). [DOI] [PubMed] [Google Scholar]
  • 24. ) Parsonnet , J. , Friedman , G. D. , Vandersteen , D. P. , Chang , Y. , Vogelman , J. H. , Orentreich , N. and Sibley , R. K.Helicobacter pylori infection and the risk of gastric carcinoma . JV. Engl. J. Med. , 325 , 1127 – 1131 ( 1991. ). [DOI] [PubMed] [Google Scholar]
  • 25. ) Nomura , A. , Stemmermann , G. N. , Chyou , P.‐H. , Kato , I. , Perez‐Perez , G. I. and Blaser , M. J.Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii . N. Engl J. Med. , 325 , 1132 – 1136 ( 1991. ). [DOI] [PubMed] [Google Scholar]
  • 26. ) Marshall , B. J. and Warren , J. R.Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration . Lancet , i , 1311 – 1315 ( 1984. ). [DOI] [PubMed] [Google Scholar]
  • 27. ) Karnes , W. E. , Jr. , Samloff , I. M. , Siurala , M. , Kekki , M. , Sipponen , P. , Kim , S. W. R. and Walsh , J. H.Positive serum antibody and negative tissue staining for Helicobacter pylori in subjects with atrophic body gastritis . Gastroenterology , 101 , 167 – 174 ( 1991. ). [DOI] [PubMed] [Google Scholar]
  • 28. ) Fox , J. G. , Correa , P. , Taylor , N. S. , Zavala , D. , Fontham , E. , Janney , F. , Rodriguez , E. , Hunter , F. and Diavolitsis , S.Campylobacter pylori‐associated gastritis and immune response in a population at increased risk gastric carcinoma . Am. J. Gastroenterology , 84 , 775 – 781 ( 1989. ). [PubMed] [Google Scholar]
  • 29. ) Segi , M. , Fukushima , I. , Fujisaku , S. , Kurihara , M. , Saito , S. , Asano , K. and Kamoi , M.An epidemiological study on cancer in Japan . Gann , 48 ( Suppl. ), 1 – 63 ( 1957. ). [Google Scholar]
  • 30. ) Correa , P. , Fontham , E. , Pickle , L. W. , Chen , V. , Lin , Y. and Haenszel , W.Dietary determinants of gastric cancer in South Louisiana inhibitants . J. Natl. Cancer Inst. , 75 , 645 – 654 ( 1985. ). [PubMed] [Google Scholar]
  • 31. ) Hoey , J. , Montvernay , C. and Lambert , R.Wine and tobacco: risk factors for gastric cancer in France . Am. J. Epidemiol , 113 , 668 – 674 ( 1981. ). [DOI] [PubMed] [Google Scholar]
  • 32. ) Kahn , H. A.The Dorn Study of smoking and mortality among U.S. veterans: report of eight and one half years' observation . Natl. Cancer Inst. Monogr. , 19 , 1 – 125 ( 1966. ). [PubMed] [Google Scholar]
  • 33. ) Kneller , R. W. , McLaughlin , J. K. , Bjelke , E. , Schuman , L. M. , Blot , W. J. , Wacholder , S. , Gridley , G. , CoChien , H. T. and Fraumeni , J. F. , Jr.A cohort study of stomach cancer in a high‐risk American population . Cancer , 68 , 672 – 678 ( 1991. ). [DOI] [PubMed] [Google Scholar]
  • 34. ) Correa , P. , Haenszel , W. , Cuello , C. , Tannenbaum , S. and Archer , M.A model for gastric cancer epidemiology . Lancet , ii , 58 – 60 ( 1975. ). [DOI] [PubMed] [Google Scholar]
  • 35. ) Raineri , R. and Weisburger , J. H.Reduction of gastric carcinogens with ascorbic acid . Ann. N. Y. Acad. Sci. , 258 , 181 – 189 ( 1975. ). [DOI] [PubMed] [Google Scholar]
  • 36. ) Macklin , M. T.Inheritance of cancer of the stomach and large intestine in men . J. Natl Cancer Inst. , 24 , 551 – 571 ( 1960. ). [DOI] [PubMed] [Google Scholar]
  • 37. ) Takei , T.Statistical investigations on genetic aspects of gastric carcinoma . Jpn. J. Hum. Genet. , 13 , 67 – 80 ( 1968. ) ( in Japanese ). [PubMed] [Google Scholar]

Articles from Japanese Journal of Cancer Research : Gann are provided here courtesy of Wiley

RESOURCES