American Journal of Epidemiology Vol. 134, No. 1: 14-21
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
other |
Multivariate Analysis of the Risk of Stomach Cancer after Ulcer Surgery in an Amsterdam Cohort of Postgastrectomy Patients
1 Department of clinical Epidemiology, University Hospital Leiden, The Netherlands
2 Department of Pathology, University Hospital Leiden, The Netherlands
3 Division of Biostatistics, The Johns Hopkins Oncology Center, The Johns Hopkins Hospital Baltimore, MD
4 Department of Pathology, The Johns Hopkins University School of Medicine Baltimore, MD
5 Department of Medicine, Division of Gastroenterology, The Johns Hopkins University School of Medicine Baltimore, MD
6 Department of Gastroenterology, Academic Medical Center Amsterdam, The Netherlands
7 Visiting scholar in the Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
Reprint requests to Dr. G J A. Offerhaus, Department of Pathology, University Hospital, P. O. Box 9603, 2300 RC Leiden, The Netherlands.
Although gastric cancer incidence is decreasing in the western world, it remains an important cause of death, and there has been debate about screening persons who have undergone gastrectomy for benign ulcers. The authors analyzed risk factors for stomach cancer mortality in an Amsterdam cohort of 2, 633 postgastrectomy patients, followed from their initial surgery between 1931 and 1960 until 1975, with 99.7% complete follow-up. Increased stomach cancer mortality was observed in the study population (compared with the general Dutch population) among mates 25 years or more after surgery (observed/expected, 5.0; 95% confidence interval (Cl) 2.8–8.3), and among females 15–24 years postoperatively (observed/expected, 3.5; 95% CI 1.0–9.0). A muttivariate Poisson regression analysis showed that after control for age at time of surgery and calendar year of operation, the most important risk factors were time since surgery (0–4 years, relative risk (RR) = 1.0; 5–14 years, RR = 4.1, 95% CI 0.93–18.5; 15–24 years, RR = 9.4, 95% Cl 2.1–42.3; and 25–46 years, RR = 55.6, 95% Cl 11.7–265.4) and ulcer location (gastric versus duodenal ulcer, RR = 2.6, 95% Cl 1.4–4.8). Surveillance for postgastrectomy cancer could be considered 15–25 years after a patient undergoes surgery for gastric ulcer disease. Am J Epidemiol 1991; 134: 14–21.
cohort studies; gastrectomy; peptic ulcer; regression analysis; risk factors; stomach neoplasms
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M Tascilar, B P van Rees, P D J Sturm, G N J Tytgat, R H Hruban, S N Goodman, F M Giardiello, G J A Offerhaus, and A C Tersmette Pancreatic cancer after remote peptic ulcer surgery J. Clin. Pathol., May 1, 2002; 55(5): 340 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Helicobacter and Cancer Collaborative Group Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts Gut, September 1, 2001; 49(3): 347 - 353. [Abstract] [Full Text] [PDF]
|
|