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Alcoholic Liver Disease Is Associated with an Increased Risk of Gastric Cancer
Tae Hoon Ha1, Byeong Gwan Kim1, Donghyong Jeong1
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Hospital, 5 Gil 20, Boramae-Road, Dongjak-Gu, Seoul, 156-707, Korea.
Background:
Little information is available regarding the relationship between alcoholic liver diseases (ALD) and the development of gastric neoplasia.
Aim:
The aim of this study was to examine whether ALD is associated with the increased risk of gastric neoplasia.
Methods:
We reviewed the medical records 514 patients diagnosed with ALD at Seoul Metropolitan Government Boramae Hospital between January 2000 and December 2011. Control subjects were selected by using propensity score matching (age, sex, and body mass index) from 8190 members of the general population who underwent EGD for screening for gastric neoplasia at Boramae Health Promotion Center during the study period. We compared the frequency of gastric neoplasia between the two groups and evaluated the risk factors for the development of gastric cancer in patients with ALD. In addition, we compared the frequency of gastric cancer between patients with ALD and those with nonalcoholic steatohepatitis (NASH).
Results:
Of the 514 patients with ALD, 16 patients (3.1 %) had gastric neoplasia, including 14 gastric cancers (2.7 %). The odds of detecting a gastric cancer in ALD patients were approximately 4.77 times greater than in healthy controls [odds ratio (OR) 4.77; 95 % confidence interval (CI) 1.36-16.69; P = 0.007]. ALD (OR 5.32, 95 % CI 1.51-18.68, P = 0.009) was found to be an independent risk factor by multivariate logistic analysis. However, there were no significant differences in the prevalence of gastric adenoma and gastric cancer between patients with ALD and those with NASH.
Conclusions:
The rate of gastric cancer was significantly higher in patients with ALD than in healthy controls, suggesting that strict endoscopic surveillance is warranted in patients with ALD.
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