Risk of Stomach Cancer in Patients with Peptic Ulcer Disease

Abstract

Abstract. The relation between peptic ulcer and stomach cancer has long been disputed, but there is accumulating evidence that gastric ulcer disease is positively associated and duodenal ulcerations negatively associated with the risk of developing stomach cancer. As Helicobacter pylori infection is associated with both types of ulceration and stomach cancer, the varying outcomes of the infection indicate that factors other than the infection must be of importance. At present, there is no convincing evidence that pharmacologic inhibition of acid secretion for treatment of peptic ulcer increases the risk of stomach cancer. However, some recent studies indicate that prolonged treatment with proton pump inhibitors may accelerate the development of atrophic gastritis, a risk factor for stomach cancer, in individuals infected with H. pylori. It has repeatedly been shown that there is an at least twofold increased risk of stomach cancer 15 years after gastric resection for peptic ulcer disease, and that the risk increases with the passage of time. Whether vagotomy has the same risk-increasing effect is still unclear.

Roles of Radiation Dose and Chemotherapy in the Etiology of Stomach Cancer as a Second Malignancy

“…Furthermore, the age-standardized incidence of stomach cancer in Japan (62 of 100,000 males) is much higher than in the Netherlands (12.4 of 100,000 males) (26,32). In addition, the risk of stomach cancer after relatively low radiation doses among peptic ulcer patients may be related to their predisposition to develop stomach cancer (33,34).…”

No Evidence for an Association between JC Polyomavirus Infection and Gastroduodenal Diseases

“…GC is still the second most frequent cause of cancer death in the world [2,3]. Gastroduodenal ulcers are regarded as a risk factor for GC, and approximately 2% of patients with GC showed evidence of GU [4,5]. It has been suggested that both genetic and environmental factors play a role in the causation of GC and gastroduodenal diseases.…”

Achlorhydria is associated with gastric microbial overgrowth and development of cancer: Lessons learned from the gastrin knockout mouse

“…Differences in gastric acidity may also explain why H. pylori patients with gastric ulcers have a higher risk for gastric cancer, whereas H. pylori patients with duodenal ulcers have a lower than average risk for developing gastric cancer [118]. A recent study in man showed that achlorhydria alone is not associated with cancer, but that additional risk factors are needed [119].…”