Cancer risk following pernicious anaemia

Abstract

Summary A computer-based file of all Veterans Administration (VA) hospitalisation records for the period 1969-1985 was used to identify and follow for cancer development a cohort of 5,161 white males with pernicious anaemia. A total of 34,915 person-years were accrued, with an average length of follow-up of 6.8 years. A total of 481 cancers were diagnosed, slightly higher than the number expected (SIR= 1.2). Significant excesses were observed for cancers of the buccal cavity and pharynx (1.8) and stomach (3.2), and for melanoma (2

Pernicious anaemia and cancer risk in Denmark

“…In this cohort study of patients with PA we found a two-fold increase in the risk for stomach cancer in accordance with previous estimates (Blackburn et al, 1968;Brinton et al, 1989;Hsing et al, 1993). Our finding of an excess of cancer of the buccal cavity and pharynx is consistent with findings in the two large US and Swedish studies (Brinton et al, 1989;Hsing et al, 1993).…”

“…Our finding of an excess of cancer of the buccal cavity and pharynx is consistent with findings in the two large US and Swedish studies (Brinton et al, 1989;Hsing et al, 1993). We have no information on important risk factors such as alcohol intake and smoking habits but two cases of buccal cavity and pharynx cancer had mention of alcoholism in the hospital record.…”

“…Such changes, however, are not reflected in excess risks of small intestine and haematopoietic cancers comparable to those of buccal cavity, pharynx and stomach cancers. Risks for some lymphatic and haematological cancers were increased but not significantly as in previous investigations (Brinton et al, 1989;Hsing et al, 1993). The reason for the difference between results may be that we, in contrast to the previous studies, excluded the first year of follow-up, where there was an accumulation of non-Hodgkin's lymphoma, multiple myeloma and myeloid leukaemia in our study.…”

“…Several previous studies have documented an increased incidence of stomach cancer in patients with pernicious anaemia (PA) (Blackburn et al, 1968;Elsborg and Mosbech, 1979;Borch et al, 1988;Brinton et al, 1989;Hsing et al, 1993). An increase in the risk for other upper gastrointestinal cancers such as buccal cavity and pharynx (Brinton et al, 1989;Hsing et al, 1993) and oesophagus (Hsing et al, 1993) has also been reported, as well as increases for other digestive organ cancers [liver, biliary tract and pancreas (Hsing et al, 1993)], though these cancers have been investigated less extensively among PA patients than stomach cancer.…”

“…An increase in the risk for other upper gastrointestinal cancers such as buccal cavity and pharynx (Brinton et al, 1989;Hsing et al, 1993) and oesophagus (Hsing et al, 1993) has also been reported, as well as increases for other digestive organ cancers [liver, biliary tract and pancreas (Hsing et al, 1993)], though these cancers have been investigated less extensively among PA patients than stomach cancer. Of possible relevance to the autoimmune process in PA, studies in the US (Brinton et al, 1989) and Sweden (Hsing et al, 1993) have also reported increased risks for multiple myeloma and myeloid leukaemia. We have performed a linkage study similar in size to the large US and Swedish studies between the nationwide Hospital Discharge and Cancer Registries in Denmark in order to clarify further the risk for gastrointestinal and other cancers among patients with PA.…”