Pernicious Anemia and Gastric Carcinoma.

Systematic review: gastric cancer incidence in pernicious anaemia

“…These articles were screened on the basis of title and abstract and, after the application of our inclusion and exclusion criteria, 71 articles were retrieved for full‐paper evaluation. Of these 71 full‐papers, 27 met eligibility criteria and were subjected to data extraction …”

“…Patients had a median age over 50 years in all studies. In particular, five studies included patients between 50 and 60 years, six studies between 61 and 70 years eight studies over 71 years . The majority of the 27 studies were European, in particular 11 (40.8%) were from Northern Europe (Denmark, Finland, Sweden) and 7 (25.9%) from other European countries (United Kingdom, Italy, Spain, Germany).…”

“…Diagnostic criteria for the diagnosis of PA were carefully described in 22 (81.5%) studies. In particular, clinical criteria such as blood tests (macrocytic anaemia, low vitamin B 12 , iron, gastrin, pepsinogen I), positive Schilling test, gastric pH, megaloblastic bone marrow or neuropathy (subacute combined cord degeneration, peripheral neuropathy, dementia) were used in 17 studies; data were extracted on the basis of International Classification of Disease (ICD) in four studies and using hospital records in one study . Five studies included patients with PA without providing further details.…”

“…Five studies included patients with PA without providing further details. The sources of the patients differed: 14 studies included patients hospitalised for PA and after followed‐up as out‐patients, 4 studies included hospitalised patients representative of general population, 2 studies included both inpatients and out‐patients and 3 studies included out‐patients referred to haematological or gastroenterological units for anaemia or gastrointestinal symptoms . Three studies lacked information about the origin of participants, while in the Blackburn study, patients were recorded in the files of eight PA clinics, but it was not indicated whether the patients were hospitalised or not.…”

Atrophic Gastritis as a Possible Precursor of Gastric Carcinoma and Pernicious Anemia Results of follow‐up examinations

“…with gastric carcinoma (1,5,24,25,28,29,30,31,32,36,37,41,42,43,46,49,59,66,69,75,79,82) and almost invariably in pernicious anemia of adults (6,11,12,13,14,15,17,27,32,35,47,48,49,55,70,72,81). Some evidencc has been presented suggesting that a great many gastric carcinomas start from atrophic gastritis with intestinal metaplasia (8,22,29,37,44,52,56,82).…”