Risk of digestive tract cancer in patients with peptic ulcers

Thursday, October 11, 2012 — Poster Session III
10:00 a.m. – Noon	Natcher Conference Center, Building 45	NCI	EPID-15

Authors

• S.W. Lin
• C.C. Abnet
• W. Wicker
• J.L. Warren
• R. Parsons
• E.A. Engels
• N.D. Freedman

Abstract

We studied the association between peptic ulcers and digestive tract cancers in the U.S. Surveillance Epidemiology and End Results (SEER)-Medicare database. Elderly cases of digestive tract cancers (aged 66+ years) were ascertained (1992-2005), and 100,000 age-, sex-, and calendar-year-matched controls were selected from a 5% random sample of Medicare beneficiaries. Gastric and duodenal ulcers were identified from Medicare claims, and associations with incident digestive tract cancers were estimated from logistic regression models. Gastric ulcers were associated with increased gastric cardia adenocarcinoma (n=5,749; odds ratio (OR) 1.50, 95% confidence interval (CI) 1.25-1.79), gastric non-cardia adenocarcinoma (n=13,366; OR 2.08, CI 1.87-2.32), small intestine carcinoids (n=1,684; OR 1.76 (1.31-2.37)), and liver cancer (n=10,662; OR 2.55 (2.28-2.85)) risk; and distal colon (n=42,222; OR 0.83(0.75-0.91)) and rectal (n=25,555; OR 0.72(0.64-0.82)) cancer risk. By contrast, duodenal ulcers were associated with increased small intestine adenocarcinoma (n=1,538; OR 2.14(1.64-2.52)) and liver cancer (OR 2.20(1.93-2.52)) risk. Neither ulcer was associated with esophageal, proximal colon, gallbladder, or pancreatic cancer risk. Because Helicobacter pylori infection is the leading cause of peptic ulcer, these findings raise the hypothesis that H. pylori infection is associated with not only gastric cancer, but also with altered risk of other cancers in the digestive tract.

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