[Pernicious anemia as a risk factor for development of stomach cancer].
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Biomedical subjects
Publications and source records attributed to J Mosbech.
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In order to assess the risk of gastric cancer (GC) developing in patients with pernicious anaemia (PA), the prevalence of PA was analysed in all patients with GC notified to the Danish Cancer Registry in 1972. Among 877 patients with GC, PA had previously been diagnosed in 19 (2.2%). In seven of these, PA had been diagnosed only shortly before GC. Accordingly, the diagnosis of PA could be regarded as unquestionable only in the remaining 12 cases (1.3%). In either case, the frequency of PA was significantly higher than in a reference group of patients with cancer of the colon who had been selected in the same way. Calculation of the incidence of GC in PA patients showed that this was about three times higher than in the general population. The annual risk of GC was calculated to be 0.3%. In PA patients, the tumour was primarily localized to the body and fundus of the stomach, whereas it mainly involved the antral and pyloric region in patients without PA. In view of the low cancer rate it is concluded that routine gastroscopy and barium meal examination are not indicated in PA patients in general. Whenever a patient with PA complains of dyspepsia, examinations with gastroscopy and barium meal should, however, be carried out on liberal indications.
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In samples of adult men from two Scandinavian populations with 4-fold differences in colon cancer incidence, a comparison was made of estimated food records over 4 days, defecation habits, mouth-to-anus transit time, and stool weight. The "high incidence" group consumed more white wheat breads and total meat and beer, but less potatoes and milk than the "low incidence" group. Defecation habits were similar. Transit time and stool weight had few significant correlations with diet and defecation habits, but stool weights were higher in the low incidence group. The results are consistent with a possible protective role of dietary fiber, unrelated to transit time.
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The increase in mortality from alcohol induced cirrhosis of the liver in Sweden, Norway, Finland and Denmark from 1961 to 1974 is compared. Mortality from alcoholic cirrhosis of the liver increased in Finland and Denmark tenfold and fivefold respectively from 1961 to 1974. The increase has been particularly marked since 1968. In Sweden a threefold increase and in Norway a doubling of mortality in males was ascribed to alcohol induced liver cirrhosis. Mortality from non-alcoholic cirrhosis of the liver remained practically unchanged during the period. Increases in mortality from liver cirrhosis due to alcohol abuse run parallel with increases in alcohol consumption; the countries with the highest mortality have the highest consumption. The distribution of consumption of beer, wine and spirit is compared in the four countries: consumption of spirits predominates in Sweden, in Finland spirits and beer, in Denmark beer and wine and in Norway spirits and beer. Doubling of alcohol consumption in a country is followed by a fourfold increase in the number of addicts, and fourfold increase in alcohol induced diseases.
The mortality from ulcerative colitis in Denmark, calculated on the basis of the mortality statistics, was 0.5/100,000/year for the period 1960-69. The total material consists of 110 females and 108 males with ulcerative colitis. The mortality showed a decreasing tendency during the study period, but the fall was not significant. The distribution of the deaths between rural and urban areas corresponded to the distribution of the general population. 93% of the deaths took place in hospital, the greater part in the surgical departments.
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