Long‐term risk of gastrointestinal cancers in persons with gastric or duodenal ulcers

Abstract

Peptic ulcer predicts gastric cancer. It is controversial if peptic ulcers predict other gastrointestinal cancers, potentially related to Helicobacter pylori or shared lifestyle factors. We hypothesized that gastric and duodenal ulcers may have different impact on the risk of gastrointestinal cancers. In a nationwide cohort study using Danish medical databases 1994–2013, we quantified the risk of gastric and other gastrointestinal cancers among patients with duodenal ulcers (dominantly H. pylori‐related) and gastric ulcers (dominantly lifestyle‐related) compared with the general population. We started follow‐up 1‐year after ulcer diagnosis to avoid detection bias and calculated absolute risks of cancer and standardized incidence ratios (SIRs). We identified 54,565 patients with gastric ulcers and 38,576 patients with duodenal ulcers. Patient characteristics were similar in the two cohorts. The 1–5‐year risk of any gastrointestinal cancer was slightly higher for gastric ulcers patients (2.1%) than for duodenal ulcers patients (2.0%), and SIRs were 1.38 (95% CI: 1.31–1.44) and 1.30 (95% CI: 1.23–1.37), respectively. The SIR of gastric cancer was higher among patients with gastric ulcer than duodenal ulcer (1.92 vs. 1.38), while the SIRs for other gastrointestinal cancers were similar (1.33 vs. 1.29). Compared with gastric ulcer patients, duodenal ulcer patients were at lower risk of smoking‐ and alcohol‐related gastrointestinal cancers. The risk of nongastric gastrointestinal cancers is increased both for patients with gastric ulcers and with duodenal ulcers, but absolute risks are low. H. pylori may be less important for the development of nongastric gastrointestinal cancer than hypothesized.

Combined aspirin and apatinib treatment suppresses gastric cancer cell proliferation

“…The anti-inflammatory effects of aspirin are reported to be mediated by PPARα activation ( 20 ). Moreover, aspirin has also been demonstrated to reduce the risk of developing GC ( 21 ), although the mechanisms underlying this effect remain unknown.…”

Increased epithelial permeability syndrome in organic diseases of the upper gastrointestinal tract: systematization of literature data

“…Данные заболевания желудка, ассоциированные с инфекцией H. pylori, рассматриваются как факторы риска РЖ [1,3,34]. Еще в 1994 г. Международное агентство по изучению рака (IARС) отнесло инфекцию H. pylori к канцерогенам I класса [35] [39,40].…”

Identified a disintegrin and metalloproteinase with thrombospondin motifs 6 serve as a novel gastric cancer prognostic biomarker by bioinformatics analysis

“…The GC development may be a process of long-term synergistic action of multiple factors. GC might be triggered by pathogenic infections, such as Helicobacter pylori (HP) [ 6–9 ] or gastric ulcers [ 10 ], chronic atrophic gastritis [ 11 ], carcinogens such as nitrite in food [ 12 ], smoking [ 13 , 14 ], and long-term drinking [ 15 ]. Despite the immense progress made in the clinical management of GC, the prognosis and survival rates of patients remain poor.…”