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Atrophic gastritis and the risk of incident colorectal cancer

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Abstract

Previous studies evaluating whether risk factors for gastric cancer are also associated with colorectal cancer (CRC) have shown inconsistent results. We prospectively examined the association of atrophic gastritis, a pre-malignant condition for gastric cancer and long-term sequelae common to many exposure factors, and the risk of incident CRC.

Methods

A total of 20,928 Finnish male smokers, aged 50–69, who were participants in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC) had serum pepsinogen I (SPGI) levels measured. Participants with low SPGI levels (<25 μg/l; n = 1,665) were invited for gastroscopy. Of these, 1,059 (63.6%) participants underwent gastroscopy and atrophic gastritis was histologically confirmed in 1,006 (95.0%) participants. We used Cox proportional hazards regression to evaluate the risk of incident CRC.

Results

During a mean follow-up of 11.3 years (236,258 person-years), 425 incident CRCs were diagnosed. The incidence rates were 1.82, 1.48, and 1.82 per 1,000 person-years of follow-up for participants with normal SPGI (≥25 μg/l), low SPGI, and histologically confirmed atrophic gastritis, respectively. Compared to subjects with normal SPGI, there was no increased risk of CRC among subjects with low SPGI (Adjusted Hazard Ratio (HR) = 0.71; 95% CI: 0.47–1.05) and among those with histologically confirmed atrophic gastritis (Adjusted HR = 0.86; 95% CI: 0.55–1.34).

Conclusion

Atrophic gastritis is not associated with an increased risk of colorectal cancer among male smokers.

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Abbreviations

ATBC:

Alpha-tocopherol, beta-carotene cancer prevention study

CI:

Confidence interval

CRC:

Colorectal cancer

HR:

Hazard ratio

SPGI:

Serum pepsinogen I

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Acknowledgments

This research was supported by the Intramural Research Program of the National Institutes of Health, Division of Cancer Epidemiology and Genetics, National Cancer Institute, and the Division of Cancer Prevention, National Institutes of Health, Department of Health and Human Services. The funding agency had a role in the design and reporting of the study and in the decision to submit the manuscript for publication and approved the final version of the manuscript.

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Authors and Affiliations

  1. Cancer Prevention Fellowship Program, Office of Preventive Oncology, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA

    Adeyinka O. Laiyemo

  2. Biometry Research Group, Division of Cancer Prevention, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA

    Adeyinka O. Laiyemo & Pamela M. Marcus

  3. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA

    Farin Kamangar, Demetrius Albanes & Rachael Z. Stolzenberg-Solomon

  4. Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA

    Farin Kamangar

  5. Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, USA

    Philip R. Taylor

  6. Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland

    Jarmo Virtamo

  7. Cancer Prevention Fellowship Program, Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, 6130 Executive Blvd., Suite 3131, Bethesda, MD, 20892, USA

    Adeyinka O. Laiyemo

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  1. Adeyinka O. Laiyemo
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  2. Farin Kamangar
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  3. Pamela M. Marcus
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Correspondence to Adeyinka O. Laiyemo.

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Laiyemo, A.O., Kamangar, F., Marcus, P.M. et al. Atrophic gastritis and the risk of incident colorectal cancer. Cancer Causes Control 21, 163–170 (2010). https://doi.org/10.1007/s10552-009-9446-4

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  • DOI: https://doi.org/10.1007/s10552-009-9446-4

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