Gastrectomy and subsequent risk of oesophageal cancer in Milan.
OBJECTIVE
To analyse quantitatively the relationship between gastrectomy and oesophageal cancer risk.


METHODS
This was a case-control study, based on a structured questionnaire that included a problem-oriented medical history.


METHODS
A network of hospitals in the Greater Milan area between 1984 and 1992.


METHODS
Subjects were 316 incident, histologically confirmed cases of oesophageal cancer (258 males and 58 females), and 1408 controls (1031 males, 377 females), admitted to hospital for acute, non-neoplastic, non-digestive tract conditions.


RESULTS
Relative risks (RR) and the corresponding 95% confidence intervals (CI) adjusted for age and sex, plus area of residence, education, tobacco, and alcohol consumption. There was an association of borderline significance of oesophageal cancer with gastric ulcer (RR = 1.6), but not with duodenal ulcer (RR = 0.9). Among cases, 25 (7.9%) reported a history of gastrectomy, versus 29 (2.1%) of the controls. The corresponding multivariate RR was 3.8 (95% CI 2.0, 7.0). The RR of oesophageal cancer was significantly raised (RR = 3.6) within 20 years after gastrectomy, and the association seemed stronger with increasing time since gastrectomy (RR = 4.2).


CONCLUSIONS
Since gastrectomy may cause gastric hypoacidity and favour oesophageal reflux, and hence oesophagitis, the results of this study, if confirmed, are of interest to a better understanding of the mechanisms of oesophageal carcinogenesis.
La Vecchia
C
C
Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
D'Avanzo
B
B
Negri
E
E
Franceschi
S
S
Boyle
P
P
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D016022:Case-Control Studies; D004381:Duodenal Ulcer / Q000150:complications; D004522:Educational Status; D004938:Esophageal Neoplasms / Q000209:etiology*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013276:Stomach Ulcer / Q000150:complications