title: Ulcer, gastric surgery and pancreatic cancer risk: an analysis from the International Pancreatic Cancer Case-Control Consortium (PanC4).
abstract: BACKGROUND
  Peptic ulcer and its treatments have been associated to pancreatic cancer risk, although the evidence is inconsistent.
  
  
  METHODS
  We pooled 10 case-control studies within the Pancreatic Cancer Case-control Consortium (PanC4), including 4717 pancreatic cancer cases and 9374 controls, and estimated summary odds ratios (OR) using multivariable logistic regression models.
  
  
  RESULTS
  The OR for pancreatic cancer was 1.10 [95% confidence interval (CI) 0.98-1.23] for history of ulcer (OR = 1.08 for gastric and 0.97 for duodenal ulcer). The association was stronger for a diagnosis within 2 years before cancer diagnosis (OR = 2.43 for peptic, 1.75 for gastric, and 1.98 for duodenal ulcer). The OR was 1.53 (95% CI 1.15-2.03) for history of gastrectomy; however, the excess risk was limited to a gastrectomy within 2 years before cancer diagnosis (OR = 6.18, 95% CI 1.82-20.96), while no significant increased risk was observed for longer time since gastrectomy. No associations were observed for pharmacological treatments for ulcer, such as antacids, H2-receptor antagonists, or proton-pump inhibitors.
  
  
  CONCLUSIONS
  This uniquely large collaborative study does not support the hypothesis that peptic ulcer and its treatment materially affect pancreatic cancer risk. The increased risk for short-term history of ulcer and gastrectomy suggests that any such association is due to increased cancer surveillance.
authors: Department of Epidemiology, IRCCS, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan.
authors: C
authors: C
authors: Bosetti
authors: E
authors: E
authors: Lucenteforte
authors: P M
authors: PM
authors: Bracci
authors: E
authors: E
authors: Negri
authors: R E
authors: RE
authors: Neale
authors: H A
authors: HA
authors: Risch
authors: S H
authors: SH
authors: Olson
authors: S
authors: S
authors: Gallinger
authors: A B
authors: AB
authors: Miller
authors: H B
authors: HB
authors: Bueno-de-Mesquita
authors: R
authors: R
authors: Talamini
authors: J
authors: J
authors: Polesel
authors: P
authors: P
authors: Ghadirian
authors: P A
authors: PA
authors: Baghurst
authors: W
authors: W
authors: Zatonski
authors: E
authors: E
authors: Fontham
authors: E A
authors: EA
authors: Holly
authors: Y T
authors: YT
authors: Gao
authors: H
authors: H
authors: Yu
authors: R C
authors: RC
authors: Kurtz
authors: M
authors: M
authors: Cotterchio
authors: P
authors: P
authors: Maisonneuve
authors: M P
authors: MP
authors: Zeegers
authors: E J
authors: EJ
authors: Duell
authors: P
authors: P
authors: Boffetta
authors: C
authors: C
authors: La Vecchia
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D005767:Gastrointestinal Diseases / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D012307:Risk Factors; D014456:Ulcer / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery
keywords: anti-ulcer drugs; case–control study; gastrectomy; pancreatic cancer; peptic ulcer; pooled analysis
references: Gut. 1989 Nov;30(11):1558-62
references: 2599442
references: Cancer Causes Control. 1995 Jul;6(4):369-76
references: 7548725
references: Lancet. 2002 Sep 21;360(9337):933-41
references: 12354485
references: Gastroenterology. 1985 Feb;88(2):557-63
references: 2856908
references: J Clin Pathol. 2002 May;55(5):340-5
references: 11986336
references: Mol Carcinog. 2012 Jan;51(1):75-97
references: 22162233
references: Br J Cancer. 2012 Jan 3;106(1):233-9
references: 22108522
references: Cancer Causes Control. 2012 Aug;23(8):1279-88
references: 22674223
references: Gut. 1987 Aug;28(8):924-8
references: 3666558
references: Cancer Causes Control. 2007 Oct;18(8):809-19
references: 17632765
references: Cancer Causes Control. 2009 Aug;20(6):825-34
references: 19194662
references: J Natl Cancer Inst. 2010 Apr 7;102(7):502-5
references: 20181960
references: Int J Cancer. 1996 Jul 3;67(1):63-71
references: 8690527
references: J Natl Cancer Inst. 2003 Jul 2;95(13):948-60
references: 12837831
references: Eur J Cancer. 2010 Jan;46(2):370-6
references: 19782561
references: Oncology. 1990;47(6):463-6
references: 2243664
references: Cancer Causes Control. 1993 Jul;4(4):375-82
references: 8347787
references: Am J Epidemiol. 2006 Jun 1;163(11):1053-64
references: 16624970
references: JOP. 2011 Jan 05;12(1):26-31
references: 21206097
references: Gastroenterology. 2010 Feb;138(2):541-9
references: 19818786
references: BMJ. 1994 Oct 8;309(6959):901-11
references: 7755693
references: Diabetes Metab Res Rev. 2011 Mar;27(3):255-61
references: 21309046
references: Ann Oncol. 2012 Jul;23(7):1880-8
references: 22104574
references: J Natl Cancer Inst. 2001 Jun 20;93(12):937-41
references: 11416115
references: Gut. 1999 Apr;44(4):468-75
references: 10075952
references: Cancer Detect Prev. 2007;31(5):345-51
references: 18031948
references: J Natl Cancer Inst. 1986 Jan;76(1):49-60
references: 3455742
references: J Clin Epidemiol. 2001 Sep;54(9):902-6
references: 11520649
references: Int J Cancer. 1992 Aug 19;52(1):17-23
references: 1500222
references: Cancer Epidemiol Biomarkers Prev. 1996 Jan;5(1):23-7
references: 8770462
references: Eur J Gastroenterol Hepatol. 1997 Jan;9(1):33-40
references: 9031896
references: J Environ Public Health. 2012;2012:180186
references: 23319964
references: Int J Cancer. 2007 Jan 15;120(2):368-72
references: 17044024