Original articleAlimentary tractCancer Risk After Pernicious Anemia in the US Elderly Population
Section snippets
Surveillance, Epidemiology, and End Results–Medicare Data Sources
SEER is a National Cancer Institute–funded program collecting data on cancer incidence and survival from 17 US cancer registries (http://www.seer.cancer.gov), covering approximately 26% of the US population. Medicare provides federally funded health insurance for approximately 97% of persons aged 65 years and older in the United States, as well as for individuals younger than age 65 years who have a medical disability. Hospital inpatient care is included in Part A coverage, which all
Results
The characteristics of cases and controls are presented in Table 1. Cases and controls were matched on sex, age, and calendar year of case diagnosis/control selection.
Pernicious anemia was reported in 1.5% of cancer cases and controls and 66% of those identified with pernicious anemia (both cases and controls) had a record of B12 treatment (data not shown). A slightly increased risk of all cancer was observed for subjects with pernicious anemia, relative to controls (OR, 1.07; 95% CI,
Discussion
We used a very large case–control study to investigate the association between pernicious anemia and cancer. Consistent with previous, far smaller, studies,6, 7, 8, 9, 17 we noted a statistically significant increase in the risk of several malignancies, gastrointestinal and nongastrointestinal, for people with pernicious anemia. The large size of our study allowed us to explore many different cancer types by histology and subsite, whether associations differed by sex, in cases occurring close
Acknowledgments
The authors acknowledge the efforts of Brenda Edwards and Lynn Ries of the Surveillance Research Program, National Cancer Institute; the Office of Research, Development, and Information, Centers for Medicare and Medicaid Services; Information Management Services, Inc; and the Surveillance, Epidemiology, and End Results Program tumor registries in the creation of the Surveillance, Epidemiology, and End Results–Medicare database.
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Conflicts of interest The authors disclose no conflicts.
Funding This work was supported by the Intramural Research Program of the National Cancer Institute at the US National Institutes of Health.