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Cancer Risk After Pernicious Anemia in the US Elderly Population
Open accessAbstract
Background & Aims Pernicious anemia, a result of autoimmune gastritis, is the most common cause of vitamin B12 deficiency, affecting 2%–5% of the elderly population. Treatment with vitamin B12 cures the anemia, but not the gastritis. Findings from small studies indicated that patients with pernicious anemia could have an increased risk of cancer. Methods We performed a population-based, case–control study of individuals the SEER-Medicare database, comparing 1,138,390 cancer cases (66–99 y old) to 100,000 matched individuals without cancer (controls). Individuals with pernicious anemia were identified based on their medical claims within the year before selection for the study. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression, and models were adjusted for sex, age, and calendar year of diagnosis and selection. Results Compared with controls, we found individuals with pernicious anemia to be at increased risk for non-cardia gastric adenocarcinoma (OR, 2.18; 95% CI, 1.94–2.45) and gastric carcinoid tumors (OR, 11.43; 95% CI, 8.90–14.69). In addition, people with pernicious anemia have an increased risk of developing tonsilar cancer (OR, 2.00; 95% CI, 1.40–2.85), hypopharyngeal cancer (OR, 1.92; 95% CI, 1.35–2.73), esophageal squamous cell carcinoma (OR, 2.12; 95% CI, 1.76–2.55), small intestinal cancer (OR, 1.63; 95% CI, 1.32–2.02), liver cancer (OR, 1.49; 95% CI, 1.28– 1.73), myeloma (OR, 1.55; 95% CI, 1.37–1.75), acute myeloid leukemia (OR, 1.68; 95% CI, 1.46–1.93), and myelodysplastic syndrome (OR, 2.87; 95% CI, 2.53–3.26). People with pernicious anemia have a lower risk of rectal cancer than the general population (OR, 0.82; 95% CI, 0.74– 0.92). Conclusion In a population-based, case–control study of individuals the SEER-Medicare database, we found individuals with pernicious anemia to have significantly increased risks of gastric carcinoid tumors, adenocarcinomas, and other cancers located throughout the body.
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Smyth, E. C., Nilsson, M., Grabsch, H. I., van Grieken, N. C., & Lordick, F. (2020) · The Lancet · doi:10.1016/s0140-6736(20)31288-5 · Cited by 4,803
Pimentel-Nunes, P., Libânio, D., Marcos-Pinto, R., Areia, M., Leja, M., Esposito, G., Garrido, M., Kikuste, I., Megraud, F., Matysiak-Budnik, T., et al. (2019) · Endoscopy · doi:10.1055/a-0859-1883 · Cited by 993
Banks, M., Graham, D., Jansen, M., Gotoda, T., Coda, S., di Pietro, M., Uedo, N., Bhandari, P., Pritchard, D. M., Kuipers, E. J., et al. (2019) · Gut · doi:10.1136/gutjnl-2018-318126 · Cited by 647
Zhang, N., Li, R.-H., Ma, L., Li, N., Shan, P.-Y., Wang, X.-B., & Liu, A.-F. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.00001 · Cited by 490
Lenti, M. V., Rugge, M., Lahner, E., Miceli, E., Toh, B.-H., Genta, R. M., De Block, C., Hershko, C., & Di Sabatino, A. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-0187-8 · Cited by 350
Metadata
- Authors
- Murphy, G., Dawsey, S. M., Engels, E. A., Ricker, W., Parsons, R., Etemadi, A., Lin, S.-W., Abnet, C. C., & Freedman, N. D.
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 13
- Issue
- 13
- Pages
- 2282-2289.e4
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W813528839
- Cited by
- 180
- References
- 0
- FWCI
- 8.75
- Type
- journal article
- Language
- en
- Open access
- green
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- Murphy, G., Dawsey, S. M., Engels, E. A., Ricker, W., Parsons, R., Etemadi, A., Lin, S.-W., Abnet, C. C., & Freedman, N. D. (2015). Cancer Risk After Pernicious Anemia in the US Elderly Population. Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2015.05.040
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