RÉSUMÉ
OBJECTIVES: A number of studies have demonstrated a trophic effect of gastrin on pancreatic cancer cells in vitro. Pernicious anemia (PA) is a clinical condition characterized by chronic hypergastrinemia. The aim of this study was to determine if PA is a risk factor for pancreatic cancer. METHODS: This study is a retrospective cohort study using The Health Improvement Network database, which contains comprehensive health information on 7.5 million patients in the United Kingdom from 1993 to 2009. All patients with PA in the study cohort were identified and composed of the exposed group. Each exposed patient was matched on practice site, sex, and age with up to 4 unexposed patients without PA. The outcome was incident pancreatic cancer. The hazard ratio and 95% confidence intervals were estimated using multivariable Cox regression analysis. RESULTS: We identified 15,324 patients with PA and 55,094 unexposed patients. Mean follow-up time was similar between groups (exposed 4.31 [SD, 3.38] years, unexposed 4.63 [SD, 3.44] years). The multivariable adjusted hazard ratio for pancreatic cancer associated with PA was 1.16 (95% confidence interval, 0.77-1.76; P = 0.47). CONCLUSIONS: There is no significant association between PA and the risk of pancreatic cancer.
Sujet(s)
Adénocarcinome/épidémiologie , Anémie pernicieuse/épidémiologie , Carcinome du canal pancréatique/épidémiologie , Tumeurs du pancréas/épidémiologie , Adénocarcinome/étiologie , Sujet âgé , Sujet âgé de 80 ans ou plus , Anémie pernicieuse/complications , Carcinome du canal pancréatique/étiologie , Femelle , Systèmes d'information sur la santé/statistiques et données numériques , Humains , Incidence , Mâle , Adulte d'âge moyen , Analyse multifactorielle , Tumeurs du pancréas/étiologie , Modèles des risques proportionnels , Analyse de régression , Études rétrospectives , Appréciation des risques/méthodes , Appréciation des risques/statistiques et données numériques , Royaume-Uni/épidémiologieRÉSUMÉ
Pernicious anemia is widely regarded as a disease of the elderly. However, it is expressed differently in black women, among the most striking differences being their younger age at presentation of the disease compared with whites. We now compared 92 Latin-American patients with 115 white and 100 black patients to see if similar age differences occur in other racial groups. Latin-American men and women were both significantly younger than white men and women, and were similar in age to blacks. Only 21% of Latin-American patients were 70 years of age or older, compared with 49% of whites. It is apparent that pernicious anemia is indeed predominantly a disease of the elderly in whites but that this is not the case in other racial groups.
Sujet(s)
Anémie pernicieuse/ethnologie , Hispanique ou Latino , Adolescent , Adulte , Facteurs âges , Sujet âgé , Sujet âgé de 80 ans ou plus , Anémie pernicieuse/épidémiologie , 38410 , Californie , Amérique centrale/ethnologie , Enfant , Femelle , Humains , Mâle , Mexique/ethnologie , Adulte d'âge moyen , Amérique du Sud/ethnologie , 38413Sujet(s)
Carence en acide folique/épidémiologie , Adolescent , Adulte , 1766 , Sujet âgé , Anémie macrocytaire/épidémiologie , Anémie pernicieuse/épidémiologie , Enfant , Enfant d'âge préscolaire , Tumeurs de l'oesophage/épidémiologie , Femelle , Carence en acide folique/étiologie , Hémoglobinopathies/épidémiologie , Humains , Nourrisson , Mâle , Adulte d'âge moyen , Antilles néerlandaises , Grossesse , Complications de la grossesse , Sprue tropicale/épidémiologie , Maladies de l'estomac/épidémiologie , Tumeurs de l'estomac/épidémiologie , Carence en vitamine B12/épidémiologie , Carence en vitamine B12/étiologieRÉSUMÉ
Clinical and laboratory details are given on 10 negro patients with pernicious anaemia admitted to the University College Hospital in Jamaica in the 30 months from January, 1958, to June, 1960. All showed the usual clinical and laboratory features of pernicious anaemia; and in the patients on whom these tests were carried out the Schilling test and gastric biopsy findings were characteristic. Anorexia and loss of weight were conspicuous features. It is thought that the rarity of this disease in the negro has been overemphasized and that hospital statitics may be misleading in this respect. The literature on pernicious anaemia in other parts of the tropics is briefly reviewed. There is evidence that, in addition to the basic gastric lesion, dietary and economic factors may play a part in the genesis of the disease (AU)