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Increased risk of laryngeal and pharyngeal cancer after gastrectomy for ulcer disease in a population-based cohort study.

AbstractBACKGROUND:
Gastrectomy has been indicated as a risk factor for laryngeal cancer, and possibly also for pharyngeal cancer, but few studies are available. The postulated mechanism is increased bile reflux following gastrectomy.
METHODS:
This was a population-based cohort study of patients who underwent gastrectomy for peptic ulcer disease between 1964 and 2008 in Sweden. Follow-up data for cancer was obtained from the Swedish Cancer Register. Relative risk was calculated as standardised incidence ratios (SIRs) with 95% confidence intervals (CIs).
RESULTS:
The gastrectomy cohort comprises 19 767 patients, contributing 348 231 person-years at risk. The observed number of patients with laryngeal (n=56) and pharyngeal cancer (n=28) was two-fold higher than the expected (SIR: 2.0, 95% CI: 1.5-2.6 and SIR: 2.4, 95% CI: 1.6-3.5, respectively). After exclusion of 5536 cohort members with tobacco- or alcohol-related disease, the point SIRs remained increased (SIR: 1.6, 95% CI: 1.1-2.2 and SIR: 1.7, 95% CI: 0.9-2.8, respectively). The SIRs of laryngeal and pharyngeal cancer increased with time after gastrectomy (P for trend <0.0001), and were particularly increased 30 years after gastrectomy (SIR: 4.8, 95% CI: 2.1-9.5 and SIR: 10.2, 95% CI: 3.7-22.3, respectively).
CONCLUSION:
Gastrectomy for peptic ulcer disease might entail a long-term increased risk of laryngeal and pharyngeal cancer.
AuthorsJ Lagergren, A Lindam
JournalBritish journal of cancer (Br J Cancer) Vol. 106 Issue 7 Pg. 1342-5 (Mar 27 2012) ISSN: 1532-1827 [Electronic] England
PMID22453126 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Cohort Studies
  • Female
  • Gastrectomy (adverse effects)
  • Humans
  • Laryngeal Neoplasms (epidemiology)
  • Male
  • Middle Aged
  • Peptic Ulcer (surgery)
  • Pharyngeal Neoplasms (epidemiology)
  • Risk Assessment
  • Sweden (epidemiology)

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