title: Gastric cancer among peptic ulcer patients: retrospective, long-term follow-up.
abstract: BACKGROUND
  Patients with duodenal ulcer are not at high risk although Helicobacter pylori infection is no doubt associated with gastric cancer development. However, little is known about the risk after long-term follow-up.
  
  
  OBJECTIVE
  We investigated the incidence for gastric cancer development in peptic ulcer patients in a long term.
  
  
  METHODS
  Between 1965 and 2004, endoscopic follow-up of more than 1 year was conducted on 1504 peptic ulcer patients in our hospital. They consisted of 978 gastric ulcer patients, 444 duodenal ulcer patients and 82 gastric and duodenal ulcer patients. Gastric and duodenal ulcer patients were excluded from the analysis because of their limited number.
  
  
  RESULTS
  Gastric cancers developed in 32 (3.3%) of gastric ulcer patients and 3 (0.68%) of duodenal ulcer patients. Kaplan-Meier analysis showed that the incidence of gastric cancer in duodenal ulcer patients was significantly lower than that in gastric ulcer patients (log-rank test, p=0.0059). Cox's proportional hazard model denoted the relative risk for duodenal ulcer against gastric ulcer adjusted by sex and age as 0.23 (95% CI: 0.072-0.77, p=0.016).
  
  
  CONCLUSIONS
  The risk for patients with duodenal ulcer to develop gastric cancer over the long term is significantly less than in those with gastric ulcer.
authors.affiliation: Division of Gastroenterology, Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Tokyo 100-0005, Japan. masako-og@umin.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Ogura
authors.forename: Y
authors.initials: Y
authors.lastname: Yamaji
authors.forename: Y
authors.initials: Y
authors.lastname: Hikiba
authors.forename: S
authors.initials: S
authors.lastname: Maeda
authors.forename: M
authors.initials: M
authors.lastname: Matsumura
authors.forename: K
authors.initials: K
authors.lastname: Okano
authors.forename: R
authors.initials: R
authors.lastname: Sassa
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.forename: T
authors.initials: T
authors.lastname: Kawabe
authors.forename: M
authors.initials: M
authors.lastname: Omata
mesh_terms: D004381:Duodenal Ulcer / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000453:epidemiology*; D013276:Stomach Ulcer / Q000453:epidemiology*