Risk of cancer following partial gastrectomy for benign ulcer disease

Abstract

The relative risk of developing cancer after partial gastrectomy for benign ulcer disease, expressed as the standardized incidence ratio, was examined in a population-based cohort comprising 6459 patients operated on between 1950 and 1958. Follow-up to 1983 revealed 1112 patients with cancer versus 1128 expected cases (relative risk 1·0 (95 per cent confidence interval (c.i.) 0·9–1·1)). The overall risk increased over time; it was higher in younger than in older patients but was not related to sex, surgical procedure (Billroth I or II gastrectomy) or diagnosis at operation (duodenal or stomach ulcer). There was an increased risk for lung cancer (relative risk 1·5 (95 per cent c.i. 1·2–1·7)), for oesophageal cancer in patients operated on for stomach ulcer (relative risk 2·2 (95 per cent c.i. 1·0–4·2)) and for cancer of the biliary tract in men (relative risk 1·9 (95 per cent c.i. 1·2–2·9)) and in those operated on for duodenal ulcer (relative risk 1·7 (95 per cent c.i. 1·0–2·8)). The overall risk for genital cancer in women was unchanged but decreased with increasing duration of follow-up and age. Cancers of the nervous system occurred less frequently than expected (relative risk 0·5 (95 per cent c.i. 0·3–0·8)), while the risk for cancer of the buccal cavity, lymphatic and haematopoietic systems, pancreas, breast, prostate, kidney and bladder was unchanged.