Cancer Risk After Pernicious Anemia in the US Elderly Population.
Cancer Risk After Pernicious Anemia in the US Elderly Population.
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DOI：
10.1016/j.cgh.2015.05.040
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发表时间：
2015-12
期刊：
影响因子：
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通讯作者：
Freedman ND
中科院分区：
文献类型：
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作者：
Murphy G;Dawsey SM;Engels EA;Ricker W;Parsons R;Etemadi A;Lin SW;Abnet CC;Freedman ND
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. 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. 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). 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.
