Skip to main content
SpringerLink
Log in

Analysis of the development of gastric cancer after resecting colorectal lesions using large-scale health insurance claims data

  • Original Article—Alimentary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Colorectal endoscopic resection (C-ER) is spreading due to the increase of colorectal cancer (CRC) in Japan. Gastric cancer (GC) sometimes occurs after C-ER. We aimed to analyze the status of GC after C-ER using large-scale data.

Methods

We retrospectively used commercially anonymized health insurance claims data of 5.71 million patients from 2005 to 2018, and extracted 62,392 patients ≥ 50 years old who received C-ER. The incidence and risk factors of GC were analyzed. Additionally, subjects were divided into ≥ 2 cm group and < 2 cm group and risks of GC were analyzed.

Results

The median age (range) was 58 (50–75) years and the overall rate of GC was 0.68% (423/62,392). Multivariate analysis showed that significant risk factors for GC [odds rates (OR), 95% confidence interval (CI)] were colorectal lesion size ≥ 2 cm (1.75, 1.24–2.47, p = 0.002), age ≥ 65 y.o. (1.65, 1.31–2.07, p < 0.001), male (2.35, 1. 76–3.13, p < 0.001), diabetes mellitus (1.40, 1.02–1.92, p = 0.035), liver disease (1.54, 1.06–2.24, p = 0.025), Helicobacter pylori infection (2.10, 1.65–2.67, p < 0.001), chronic atrophic gastritis (1.58, 1.14–2.18, p = 0.006), and CRC (1.72, 1.10–2.68, p = 0.017). The rate of GC in the ≥ 2 cm was significantly higher than that in < 2 cm groups (1.17% and 0.65%, p < 0.001). According to the number of significant risk factors, the rates of GC and the hazard ratios of GC (95%CI) were 0.64% and 3.64 (2.20–6.02) and 1.95% and 11.17 (6.57–19.00) for patient with 1–2 and ≥ 3 risk factors, compared with patients without risk factors.

Conclusions

Using large-scale data, risk factors for GC, including colorecal lesions ≥ 2 cm after C-ER could be investigated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The data analyzed in this study are available from JMDC Co., Ltd. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from the authors upon reasonable request with the permission of JMDC Co., Ltd.

References

  1. Cancer statistics [Internet]. Cancer Information Service, National Cancer Center (National Cancer Registry, Ministry of Health, Labour and Welfare). [Cited 2022 December 26]. Available from: https://ganjoho.jp/reg_stat/statistics/data/dl/index.html.

  2. Cancer [Internet]. World Health Organization. [Cited 2022 July 14]. Available from: International Agency for Research on Cancer. Available from: https://www.who.int/news-room/fact-sheets/detail/cancer.

  3. Zauber AG, Winawer SJ, O’Brien MJ, et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012;366:687–96.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Tanaka S, Kashida H, Saito Y, et al. Japan gastroenterological endoscopy society guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc. 2020;32:219–39.

    Article  PubMed  Google Scholar 

  5. Atkin W, Wooldrage K, Brenner A, et al. Adenoma surveillance and colorectal cancer incidence: a retrospective, multicentre, cohort study. Lancet Oncol. 2017;18:823–34.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Saito Y, Oka S, Kawamura T, et al. Colonoscopy screening and surveillance guidelines. Dig Endosc. 2021;33:486–519.

    Article  PubMed  Google Scholar 

  7. Yoshida N, Naito Y, Siah KT, et al. High incidence of metachronous advanced adenoma and cancer after endoscopic resection of colon polyps ≥ 20 mm in size. Dig Endosc. 2016;28:194–202.

    Article  PubMed  Google Scholar 

  8. Lim SB, Jeong SY, Choi HS, et al. Synchronous gastric cancer in primary sporadic colorectal cancer patients in Korea. Int J Colorectal Dis. 2008;23:61–5.

    Article  CAS  PubMed  Google Scholar 

  9. Fukase K, Kato M, Kikuchi S, et al. Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomized controlled trial. Lancet. 2008;372:392–7.

    Article  PubMed  Google Scholar 

  10. Thrift AP, Nguyen TH. Gastric cancer epidemiology. Gastrointest Endosc Clin N Am. 2021;31:425–39.

    Article  PubMed  Google Scholar 

  11. Mori G, Nakajima T, Asada K, et al. Incidence of and risk factors for metachronous gastric cancer after endoscopic resection and successful Helicobacter pylori eradication: results of a large-scale, multicenter cohort study in Japan. Gastric Cancer. 2016;19:911–8.

    Article  PubMed  Google Scholar 

  12. Ueno T, Muto M, Oya H, et al. Multiple primary cancer: an experience at the cancer institute hospital with special reference to colorectal cancer. Int J Clin Oncol. 2003;8:162–7.

    Article  PubMed  Google Scholar 

  13. Nagai K, Tanaka T, Kodaira N, et al. Data resource profile: JMDC claims database sourced from health insurance societies. J Gen Fam Med. 2021;22:118–27.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Yoshida N, Ishikawa H, Otani T, et al. Aspirin-mediated prevention of colorectal adenomas recurrence is affected by blood biochemistry and nutritional intake. Cancer Prev Res (Phila). 2022;15:837–46.

    Article  CAS  PubMed  Google Scholar 

  15. Wright FL, Green J, Canoy D, et al. Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England. BMC Med Res Methodol. 2012;12:161.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Junqueira RM, Duarte EC. Hospitalizations due to ambulatory care-sensitive conditions in the Federal District, Brazil, 2008. Rev Saude Publica. 2012;46:761–8.

    Article  PubMed  Google Scholar 

  17. Thygesen S, Christiansen CF, Charistensen S, et al. The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish national registry of patients. BMC Med Res Methodol. 2011;11:83.

    Article  PubMed  PubMed Central  Google Scholar 

  18. van den Bussche H, Schön G, Kolonko T, et al. Patterns of ambulatory medical care utilization in elderly patients with special reference to chronic diseases and multimorbidity—results from a claims data based observational study in Germany. BMC Geriatr. 2011;11:54.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.

    Article  CAS  PubMed  Google Scholar 

  20. Vogt A, Schmid S, Heinimann K, et al. Multiple primary tumours: challenges and approaches, a review. ESMO Open. 2017;2: e000172.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Noura S, Ohue M, Seki Y, et al. Second primary cancer in patients with colorectal cancer after a curative resection. Dig Surg. 2009;26:400–5.

    Article  PubMed  Google Scholar 

  22. Odani S, Tabuchi T, Nakata K, et al. Incidence and relative risk of metachronous second primary cancers for 16 cancer sites, Osaka, Japan, 2000–2015: population-based analysis. Cancer Med. 2022;11:507–19.

    Article  PubMed  Google Scholar 

  23. Guo J, Liu C, Pan J, et al. Relationship between diabetes and risk of gastric cancer: a systematic review and meta-analysis of cohort studies. Diabetes Res Clin Pract. 2022;187: 109866.

    Article  CAS  PubMed  Google Scholar 

  24. Ami R, Hatta W, Iijima K, et al. Factors associated with metachronous gastric cancer development after endoscopic submucosal dissection for early gastric cancer. J Clin Gastroenterol. 2017;51:494–9.

    Article  PubMed  Google Scholar 

  25. Shichijo S, Hirata Y, Niikura R, et al. Association between gastric cancer and the Kyoto classification of gastritis. J Gastroenterol Hepatol. 2017;32:1581–6.

    Article  PubMed  Google Scholar 

  26. Uemura N, Okamoto S, Yamamoto S, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–9.

    Article  CAS  PubMed  Google Scholar 

  27. Tak DH, Moon HS, Kang SH, et al. Prevalence and risk Factors of gastric adenoma and gastric cancer in colorectal cancer patients. Gastroenteol Res Pract. 2016;2016:2469521.

    Google Scholar 

  28. Zheng G, Sundquist K, Sundquist J, et al. Second primary cancers after gastric cancer, and gastric cancer as second primary cancer. Clin Epidemiol. 2021;13:515–25.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lee SY, Yoshida N, Dohi O, et al. Differences in prevalence of lymphovascular invasion among early gastric cancers between Korea and Japan. Gut Liver. 2017;11:383–91.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Aldridge AJ, Simson JN. Histological assessment of colorectal adenomas by size. Are polyps less than 10 mm in size clinically important? Eur J Surg. 2001;167:777–81.

    Article  CAS  PubMed  Google Scholar 

  31. Park DI, Park SH, Yoo TW, et al. The prevalence of colorectal neoplasia in patients with gastric cancer: a Korean association for the study of intestinal disease (KASID) Study. J Clin Gastroenterol. 2010;44:102–5.

    Article  PubMed  Google Scholar 

  32. Joo MK, Park JJ, Lee WW, et al. Differences in the prevalence of colorectal polyps in patients undergoing endoscopic removal of gastric adenoma or early gastric cancer and in healthy individuals. Endoscopy. 2010;42:114–20.

    Article  CAS  PubMed  Google Scholar 

  33. Kim SY, Jung SW, Hyun JJ, et al. Is colonoscopic screening necessary for patients with gastric adenoma or cancer? Dig Dis Sci. 2013;58:3263–9.

    Article  PubMed  Google Scholar 

  34. Oh SY, Park DI, Yoo TW, et al. Is gastric cancer a new indication for surveillance colonoscopy? Colon cancer is increased in gastric cancer patients. Korean J Gastroenterol. 2006;47:191–7.

    PubMed  Google Scholar 

  35. Zuo Y, Jing Z, Bie M, et al. Association between Helicobacter pylori infection and the risk of colorectal cancer: a systematic review and meta-analysis. Medicine (Baltim). 2020;99: e21832.

    Article  Google Scholar 

  36. Selgrad M, Bornschein J, Kandulski A, et al. Helicobacter pylori but not gastrin is associated with the development of colonic neoplasms. Int J Cancer. 2014;135:1127–31.

    Article  CAS  PubMed  Google Scholar 

  37. Smith AM, Watson SA. Review article: gastrin and colorectal cancer. Aliment Pharmacol Ther. 2000;14:1231–47.

    Article  CAS  PubMed  Google Scholar 

  38. Kopchick JJ, Basu R, Berryman DE, et al. Covert actions of growth hormone: fibrosis, cardiovascular diseases and cancer. Nat Rev Endocrinol. 2022;18:558–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Colorectal cancer [Internet]. World Health Organization [Cited 2023 August 7]: Available from: https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer.

  40. Arnold M, Abnet CC, Neale RE, et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020;159:335-49.e15.

    Article  PubMed  Google Scholar 

  41. Usui Y, Taniyama Y, Endo M, et al. Helicobacter pylori, homologous-recombination genes, and gastric cancer. N Engl J Med. 2023;388:1181–90.

    Article  CAS  PubMed  Google Scholar 

  42. Blair VR, McLeod M, Carneiro F, et al. Hereditary diffuse gastric cancer: updated clinical practice guidelines. Lancet Oncol. 2020;21:e386–97.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Lee GH, Malietzis G, Askari A, et al. Is right-sided colon cancer different to left-sided colorectal cancer? A systematic review. Eur J Surg Oncol. 2015;41:300–8.

    Article  CAS  PubMed  Google Scholar 

  44. Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol. 2019;16:713–32.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank all members of the Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, for their help with this study.

Funding

Nothing.

Author information

Authors and Affiliations

  1. Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Naohisa Yoshida, Yuri Tomita, Ryohei Hirose, Osamu Dohi & Yoshito Itoh

  2. Department of Clinical Drug Informatics, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan

    Ayako Maeda-Minami, Yui Kanno & Yasunari Mano

  3. Department of Molecular-Targeting Prevention, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Hideki Ishikawa & Michihiro Mutoh

Authors
  1. Naohisa Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayako Maeda-Minami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hideki Ishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michihiro Mutoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yui Kanno
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuri Tomita
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ryohei Hirose
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Osamu Dohi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yoshito Itoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yasunari Mano
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NY and HI designed this study, AM-M, YK, and YM performed statistical analysis, MM, YT, RH, OD, and YI had comprehensive comments about the results. All authors reviewed a paper and agreed with the contents.

Corresponding author

Correspondence to Naohisa Yoshida.

Ethics declarations

Conflict of interest

Naohisa Yoshida and Osamu Dohi received a research grant from Fujifilm Co. The other authors declare no conflicts of interest in association with the present study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 27 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoshida, N., Maeda-Minami, A., Ishikawa, H. et al. Analysis of the development of gastric cancer after resecting colorectal lesions using large-scale health insurance claims data. J Gastroenterol 58, 1105–1113 (2023). https://doi.org/10.1007/s00535-023-02035-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-023-02035-1

Keywords

Search

Navigation