title: Diagnosis of pernicious anemia and the risk of pancreatic cancer.
abstract: OBJECTIVE
  A number of studies have demonstrated a trophic effect of gastrin on pancreatic cancer cells in vitro. Pernicious anemia (PA) is a clinical condition characterized by chronic hypergastrinemia. The aim of this study was to determine if PA is a risk factor for pancreatic cancer.
  
  
  METHODS
  This study is a retrospective cohort study using The Health Improvement Network database, which contains comprehensive health information on 7.5 million patients in the United Kingdom from 1993 to 2009. All patients with PA in the study cohort were identified and composed of the exposed group. Each exposed patient was matched on practice site, sex, and age with up to 4 unexposed patients without PA. The outcome was incident pancreatic cancer. The hazard ratio and 95% confidence intervals were estimated using multivariable Cox regression analysis.
  
  
  RESULTS
  We identified 15,324 patients with PA and 55,094 unexposed patients. Mean follow-up time was similar between groups (exposed 4.31 [SD, 3.38] years, unexposed 4.63 [SD, 3.44] years). The multivariable adjusted hazard ratio for pancreatic cancer associated with PA was 1.16 (95% confidence interval, 0.77-1.76; P = 0.47).
  
  
  CONCLUSIONS
  There is no significant association between PA and the risk of pancreatic cancer.
authors.affiliation: From the *Department of Medicine, Gastroenterology and Nutrition Service, Memorial Sloan Kettering Cancer Center, New York, NY; and †Division of Gastroenterology, Department of Medicine, and ‡Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Pari
authors.initials: P
authors.lastname: Shah
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Rhim
authors.forename: Kevin
authors.initials: K
authors.lastname: Haynes
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Hwang
authors.forename: Yu-Xiao
authors.initials: YX
authors.lastname: Yang
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D000752:Anemia, Pernicious / Q000150:complications / Q000453:epidemiology*; D021441:Carcinoma, Pancreatic Ductal / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D063005:Health Information Systems / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology