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Family Practice Vol. 16, No. 2, 129-132
© Oxford University Press 1999

The prognostic value of gastrointestinal morbidity for gastric cancer

RJF Laheij, JBMJ Jansen, EH van de Lisdonka, JL Severensb and ALM Verbeekb

Department of Gastroenterology, University Hospital Nijmegen,
a Department of General Practice and
b Department of Epidemiology, University of Nijmegen, Nijmegen, The Netherlands.

R Laheij MSc, MIES (152), P.O. Box 9101, NL 6500 HB Nijmegen, The Netherlands.

Objective. A history of gastrointestinal disease is a risk factor for organic gastrointestinal disorders overall. We conducted a retrospective case-control study to explore whether a history of gastrointestinal disease is of prognostic value for gastric cancer.

Methods. Forty-six patients with gastric cancer were identified from a dynamic population of approximately 12 000 patients followed since 1971 in four general practices. The control subjects without gastric cancer were matched one-on-one according to age, general practice, sex and observation period. Data on gastrointestinal morbidity in the period before gastric cancer was diagnosed were obtained from the Continuous Morbidity Registration.

Results. The mean observation period between the date of enrolment in the registration and the first diagnosis of gastric carcinoma was 12 years. Although every patient with gastric cancer ultimately will develop gastrointestinal complaints, 28 of these patients had no previous gastrointestinal morbidity, in comparison with 26 control subjects. Furthermore, patients who developed gastric cancer did not have more frequent gastrointestinal morbidity in their past than the control subjects (odds ratio 0.80, 95% CI 0.32–2.03).

Conclusions. Our results suggest that a history of gastrointestinal morbidity is not of prognostic value for gastric cancer. Focusing attention on patients with a past history of gastrointestinal symptoms to detect gastric cancer may be of little value.

Keywords. Case-control study, gastric cancer, gastrointestinal disorders, prognosis..


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