Risk of stomach cancer after gastric surgery for benign conditions. A case-control study

Patients with previous gastric surgery for benign conditions are thought to be at increased risk for gastric cancer based on studies from Europe. Recommendations have been made to screen these patients repeatedly in order to detect early gastric cancers. We conducted a case-control study to estimate the risk in the United States where the rates of gastric cancer are lower. There were 521 gastric cancer cases who were matched by age, race, sex, and date of admission to an equal number of hospital controls. The odds ratio for cancer after gastric surgery was 0.7 (P = 0.4) which indicates no increased risk. The sample size was sufficient to detect risks in the range reported in previous studies. The odds ratios rose with longer postoperative intervals but were based on small numbers and were not statistically significant. This case-control study failed to demonstrate an overall increased risk for gastric cancer after surgery. Further study is needed before general screening can be endorsed in the United States.