Gastric cancer—Increased frequency in patients with achlorhydria

Abstract

This paper reports the difference noted in the frequency of gastric carcinoma in “achlorhydrics” as opposed to acid secretors in a follow-up study of 1590 individuals over 40 years of age in whom the state of gastric acidity was determined by tubeless gastric analysis with the azure resin compound and caffeine as the gastric stimulant. The authors describe the rationale of this tubeless gastric analysis technic with caffeine as the gastric stimulant and emphasize that “achlorhydria” as determined by this method indicates an abnormal gastric mucosa. Gastric carcinoma occurred in 3 of the 906 acid secretors (0.33%) and in 16 of the 684 achlorhydric individuals (2.3%) detected by the tubeless gastric analysis technic. The data show that the frequency of gastric carcinoma was about 7 times greater in the achlorhydric group than in the acid-secreting individuals. The increased incidence of achlorhydria from 19% in the fifth decade of life to 69% in the eighth decade suggested that an abnormal gastric mucosa may be a common accompaniment of aging. The increased occurrence of an abnormal mucosa was associated with a rise in frequency of gastric carcinoma from 1.6% in the fifth decade to 3.4% in the eighth decade. By contrast, the lower incidence of gastric carcinoma in acid secretors in the older age groups is probably related to an essentially normal gastric mucosa. Although the incidence of achlorhydria in the O and A blood groups was approximately equal (60% of the individuals in each blood group had achlorhydria) the frequency of carcinoma was about 4 times greater in subjects with blood group A than in those with blood group O.