Department of Molecular Medicine and Surgery, Upper Gastrointestinal Research, Karolinska Institutet, Norra Stationsgatan 67, Level 2, 17176 Stockholm, Sweden. jesper.lagergren@ki.se
Gastrectomy has been indicated as a risk factor for laryngeal cancer, and possibly also for pharyngeal cancer, but few studies are available. The postulated mechanism is increased bile reflux following gastrectomy.
This was a population-based cohort study of patients who underwent gastrectomy for peptic ulcer disease between 1964 and 2008 in Sweden. Follow-up data for cancer was obtained from the Swedish Cancer Register. Relative risk was calculated as standardised incidence ratios (SIRs) with 95% confidence intervals (CIs).
The gastrectomy cohort comprises 19?767 patients, contributing 348?231 person-years at risk. The observed number of patients with laryngeal (n=56) and pharyngeal cancer (n=28) was two-fold higher than the expected (SIR: 2.0, 95% CI: 1.5-2.6 and SIR: 2.4, 95% CI: 1.6-3.5, respectively). After exclusion of 5536 cohort members with tobacco- or alcohol-related disease, the point SIRs remained increased (SIR: 1.6, 95% CI: 1.1-2.2 and SIR: 1.7, 95% CI: 0.9-2.8, respectively). The SIRs of laryngeal and pharyngeal cancer increased with time after gastrectomy (P for trend
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Cites: Am J Gastroenterol. 2000 Sep;95(9):239811007261