This uncommissioned systematic review was subject to full peer-review.
Systematic review: gastric cancer incidence in pernicious anaemia
Article first published online: 10 DEC 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 37, Issue 4, pages 375–382, February 2013
How to Cite
Vannella, L., Lahner, E., Osborn, J. and Annibale, B. (2013), Systematic review: gastric cancer incidence in pernicious anaemia. Alimentary Pharmacology & Therapeutics, 37: 375–382. doi: 10.1111/apt.12177
- Issue published online: 22 JAN 2013
- Article first published online: 10 DEC 2012
- Manuscript Accepted: 16 NOV 2012
- Manuscript Revised: 15 NOV 2012
- Manuscript Revised: 21 AUG 2012
- Manuscript Received: 26 JUL 2012
- Italian Ministry for University and Research
- University Sapienza of Rome
Pernicious anaemia (PA) has an increased risk for gastric cancer (GC). It is not established whether PA patients need to undergo endoscopic/histological follow-up.
To provide a systematic overview of the literature on PA and the development of gastric cancer, to estimate the gastric cancer incidence-rate.
According to PRISMA, we identified studies on PA patients reporting the incidence of gastric cancer. Quality of studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Meta-analysis on annual gastric cancer incidence rates was performed.
Twenty-seven studies met eligibility criteria. 7 studies were of high, 6 of medium, 10 of low and 4 of very low quality. Gastric cancer incidence-rates ranged from 0% to 0.2% per person-years in 7 American, from 0% to 0.5% in 2 Asiatic, from 0% to 1.2% in 11 Northern European studies and from 0% to 0.9% in 7 studies from other European countries. The incidence-rates of gastric cancer ranged from 0% to 1.2% per person-years in studies which used gastroscopy, from 0.1% to 0.9% in those based on International Classification of Disease. Heterogeneity between studies was not statistically significant at the 5% level (Chi-squared test = 17.9, P = 0.08). The calculated pooled gastric cancer incidence-rate was 0.27% per person-years. Meta-analysis showed overall gastric cancer relative risk in PA as 6.8 (95% CI: 2.6–18.1).
This systematic review shows a pooled gastric cancer incidence-rate in pernicious anaemia of 0.27% per person-years and an estimated nearly sevenfold relative risk of gastric cancer in pernicious anaemia patients. Further high quality studies are needed to confirm this higher risk.