Cancer Causes & Control

, Volume 21, Issue 1, pp 163–170 | Cite as

Atrophic gastritis and the risk of incident colorectal cancer

  • Adeyinka O. Laiyemo
  • Farin Kamangar
  • Pamela M. Marcus
  • Philip R. Taylor
  • Jarmo Virtamo
  • Demetrius Albanes
  • Rachael Z. Stolzenberg-Solomon
Original paper


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.


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.


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).


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


Serum pepsinogen Atrophic gastritis Colorectal cancer 



Alpha-tocopherol, beta-carotene cancer prevention study


Confidence interval


Colorectal cancer


Hazard ratio


Serum pepsinogen I


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Copyright information

© US Government  2009

Authors and Affiliations

  • Adeyinka O. Laiyemo
    • 1
    • 2
    • 7
  • Farin Kamangar
    • 3
    • 4
  • Pamela M. Marcus
    • 2
  • Philip R. Taylor
    • 5
  • Jarmo Virtamo
    • 6
  • Demetrius Albanes
    • 3
  • Rachael Z. Stolzenberg-Solomon
    • 3
  1. 1.Cancer Prevention Fellowship Program, Office of Preventive OncologyNational Cancer Institute (NCI), National Institutes of Health (NIH)BethesdaUSA
  2. 2.Biometry Research Group, Division of Cancer PreventionNational Cancer Institute (NCI), National Institutes of Health (NIH)BethesdaUSA
  3. 3.Nutritional Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer Institute (NCI), National Institutes of Health (NIH)BethesdaUSA
  4. 4.Department of Public Health Analysis, School of Community Health and PolicyMorgan State UniversityBaltimoreUSA
  5. 5.Genetic Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer Institute (NCI), National Institutes of Health (NIH)BethesdaUSA
  6. 6.Department of Chronic Disease PreventionNational Institute for Health and WelfareHelsinkiFinland
  7. 7.Cancer Prevention Fellowship Program, Biometry Research Group, Division of Cancer PreventionNational Cancer InstituteBethesdaUSA

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