MedWire News: Researchers have found that gastric ulcers are associated with an increased risk for pancreatic cancer, suggesting that N-nitrosamine formation may be an important mechanism in pancreatic carcinogenesis.
Dominique Michaud (Imperial College London, UK) and co-researchers analyzed data collected from 51,529 male health professionals who took part in the Health Professionals Follow-Up Study initiated in 1986. Every 2 years, follow-up questionnaires were mailed to surviving cohort members to update data on potential risk factors and to identify newly diagnosed cases of peptic ulcer and pancreatic cancer.
During 18 years of follow-up, 274 individuals developed pancreatic cancer. Compared with men who never had ulcers, those who had gastric ulcers showed a significant 1.83-fold increased risk for pancreatic cancer after adjusting for smoking, history of diabetes, body mass index, and physical activity.
Furthermore, ever having had both gastric and duodenal ulcers was associated with a significantly greater 2.85-fold increased risk for pancreatic cancer compared with men who never had ulcers. In contrast, ever having a duodenal ulcer was not significantly associated with pancreatic cancer risk.
The researchers also observed that the risk for pancreatic cancer was highest for individuals who were diagnosed with a gastric ulcer within the previous 10 years (relative risk [RR]=3.66). However, this risk remained significantly increased 10-19 years after the gastric ulcer diagnosis, at a RR of 2.89.
The association between gastric ulcer and pancreatic cancer risk was more pronounced when gastric ulcer was diagnosed after age 40 years (RR=2.39) and was significantly stronger in individuals who had never smoked (RR=2.34) and had low intakes of vitamin C (RR=2.38) and vitamin E (RR=2.10).
Duodenal cancer was not related to pancreatic cancer when the team examined time components of ulcer, smoking status, and levels of vitamin C and E intake.
“The positive relation between gastric ulcer and pancreatic cancer risk might be explained by excess nitrosamine formation associated with gastric ulcer,” write the authors in the journal Gastroenterology.
They add: “Lack of association for duodenal ulcer, on the other hand, is consistent with a less crucial role of hyperacidity in the development of pancreatic cancer.”
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