Geographical variance in the risk of gastric stump cancer: no increased risk in Japan?
Geographical differences may exist in the risk of gastric stump cancer. Therefore, we performed meta-analysis of literature reports in Japan (n = 3), the USA (n = 4), and Europe (n = 20) on the risk of postgastrectomy cancer. The weighted mean relative risk of stump cancer in Japan was 0.28, 95% confidence limits 0.21-0.38 as compared to 1.53, 95% confidence limits 0.98-2.41 in the USA and 1.66, 95% confidence limits 1.55-1.79 in Europe. Thus, the risk of gastric cancer in the post-gastrectomy patient seems decreased in Japan and is significantly less than in the USA or Europe, where an increased risk exists. Since there is a high risk of gastric cancer of the intact stomach in Japan, the discovery of a low cancer risk in the gastric stump may provide evidence that these gastric cancers are two different entities.
Tersmette
A C
AC
Department of Clinical Epidemiology, University Hospital Leiden, The Netherlands.
Giardiello
F M
FM
Offerhaus
G J
GJ
Tersmette
K W
KW
Ohara
K
K
Vandenbroucke
J P
JP
Tytgat
G N
GN
D004381:Duodenal Ulcer / Q000601:surgery*; D005060:Europe; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D005843:Geography; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D015201:Meta-Analysis as Topic; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000209:etiology; D013276:Stomach Ulcer / Q000601:surgery*; D014481:United States