Cancer of the Nongastric Hollow Organs of the Gastrointestinal Tract After Gastric Surgery

To estimate the risk of esophageal, gallbladder, small-bowel, and colon cancers after gastric surgery for benign disease, all 337 residents of Olmsted County, Minnesota, who had surgical treatment of benign peptic ulcer disease during the years 1935 through 1959, were followed up. Patients were followed up for 6552 person-years of observation. No esophageal cancers developed (0.8 were expected). Members of the cohort developed one small-bowel malignant neoplasm (0.2 were expected), two gallbladder cancers (1.1 was expected), and four colon cancers (11.2 were expected), but these figures do not reflect a significant increase in the risk of these malignant neoplasms. In particular, the relative risk of developing colon cancer was only 0.4 when this analysis had 88% power to detect a relative risk of two or more. When the present investigation and two previous studies of this cohort were taken together, there was no strong evidence for an increased risk of any gastrointestinal cancer following gastric surgery.