Pernicious anemia and colorectal cancer risk - A nested case-control study

Ben Boursi; Ronac Mamtani; Kevin Haynes; Yu-Xiao Yang

doi:10.1016/j.dld.2016.07.011

Pernicious anemia and colorectal cancer risk - A nested case-control study

Dig Liver Dis. 2016 Nov;48(11):1386-1390. doi: 10.1016/j.dld.2016.07.011. Epub 2016 Jul 18.

Authors

Ben Boursi¹, Ronac Mamtani², Kevin Haynes³, Yu-Xiao Yang⁴

Affiliations

¹ Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Tel-Aviv University, Tel-Aviv, Israel.
² Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Division of Hematology/Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
³ Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
⁴ Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. Electronic address: yangy@mail.med.upenn.edu.

PMID: 27481584
DOI: 10.1016/j.dld.2016.07.011

Abstract

Background: Hypergastrinemia was shown to stimulate colonic epithelial cell proliferation.

Aims: To evaluate the association between pernicious anemia (PA), a disease with hypergastrinemia, and colorectal cancer (CRC) risk.

Methods: We conducted a nested case-control study within a large database from the UK. Cases were defined as all individuals in the cohort with at least one medical code for CRC. Controls were selected based on incidence-density sampling. For each case, up to four eligible controls were matched on age at diagnosis, sex, practice-site, and both duration and calendar time of follow-up. Exposure of interest was diagnosis of PA prior to CRC diagnosis date. The primary analysis was a multivariable conditional logistic regression.

Results: Our study included 22,098 CRC cases and 85,969 matched controls. We identified 154 (0.70%) cases and 563 (0.65%) controls with past history of PA. The adjusted OR for the association between PA and CRC risk was 1.02 (95% CI 0.85-1.22). There was no difference in the results after stratification according to sex. In a sensitivity analysis only among individuals without chronic use of proton pump inhibitors (PPIs) the adjusted OR was 1.14 (95% CI 0.90-1.45). There was no association between duration of PA and CRC risk.

Conclusion: PA is not associated with higher CRC risk.

Keywords: Colon cancer; Gastrin; Pernicious anemia; Proton pump inhibitors.

MeSH terms

Aged
Aged, 80 and over
Anemia, Pernicious / epidemiology*
Case-Control Studies
Colorectal Neoplasms / complications*
Databases, Factual
Female
Gastrins / blood*
Humans
Incidence
Logistic Models
Male
Middle Aged
Multivariate Analysis
Proton Pump Inhibitors / adverse effects*
Risk Factors
Sex Factors
United Kingdom

Substances

Gastrins
Proton Pump Inhibitors