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Malignant neoplasms after radiation therapy for peptic ulcer
Zhanat A Carr1, Ruth A Kleinerman, Marilyn Stovall
1Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA. abylkasz@mail.nih.gov
Radiation Research
|May 15, 2002
Summary
This study on U.S. peptic ulcer patients reveals radiation exposure significantly increases stomach, pancreas, and lung cancer mortality. Findings offer insights into radiation cancer risk beyond atomic bomb survivor data.
Area of Science:
- Radiation Oncology
- Epidemiology
- Cancer Research
Background:
- The Life Span Study (LSS) of atomic bomb survivors is a primary source for radiation-related cancer risk, but its applicability to the U.S. population is limited due to differing stomach cancer rates.
- A unique cohort of U.S. patients treated for peptic ulcers provides an alternative data source for assessing radiation-induced cancer risk.
Purpose of the Study:
- To investigate the long-term cancer mortality risk in U.S. patients who received radiation therapy for peptic ulcers.
- To compare radiation-related cancer risks in this cohort with general U.S. population rates and findings from the LSS.
Main Methods:
- Analysis of cancer mortality data for 3719 U.S. patients treated between 1936-1965 with radiotherapy and/or surgery/medication.
- Follow-up through 1997, with an average follow-up of 25 years, to estimate relative risks (RR) and assess radiation dose-response relationships.
Main Results:
- Significantly increased stomach cancer mortality was observed in both irradiated (O/E=3.20) and non-irradiated (O/E=1.52) patients compared to U.S. rates.
- Strong evidence of exposure-related excess mortality from stomach (RR 2.6), pancreas (RR 2.7), and lung (RR 1.5) cancers was found when including nonexposed individuals.
- Radiation dose-response relationships were observed but not statistically significant when the analysis was restricted to only exposed patients.
Conclusions:
- Radiation exposure in U.S. peptic ulcer patients is associated with increased mortality from stomach, pancreas, and lung cancers.
- The excess relative risk per gray estimate aligns with findings from the LSS, supporting the consistency of radiation risk models across different populations.
- This cohort provides valuable data for understanding radiation-induced cancer risk in a Western population, complementing existing studies.