Risk of gastric cancer following percutaneous endoscopic gastrostomy: A nationwide population-based cohort study.
OBJECTIVES
To investigate whether percutaneous endoscopic gastrostomy (PEG) tube placement is associated with increased risk of gastric cancer.


METHODS
We conducted a nationwide population-based retrospective study in Taiwan. Inpatient data from 1997 to 2010 were collected from Taiwan National Health Insurance Research Database. Patients with age less than 20 years; those with histories of PEG before 2000; those with histories of cancers; and those diagnosed with gastric cancer before or within 6 months of the first PEG procedure were excluded. Finally, 3505 patients who underwent PEG were included (PEG cohort), along with 7010 randomly-selected individuals, matched by age, sex, and year of index date, as the control cohort.


RESULTS
After adjusting for age, sex, peptic ulcer, gastritis, hypertension, diabetes and coronary artery disease, risk of gastric cancer was significantly higher in the PEG cohort (adjusted hazard ratio, 5.31; 95% confidence interval, 4.12-6.00; p = 0.011). Patients with 2 or more PEG procedures were significantly associated with increasingly developing gastric cancer risk (adjusted hazard ratio, 2.73; 95% confidence interval, 1.91-3.85; p < 0.001). The possible hypothesis may be due to chronic inflammation caused by chemical and physical conditions of the tube.


CONCLUSIONS
Patients with PEG might be associated with a greater risk of subsequent gastric cancer in Taiwan. Physicians should be aware of the link when assessing patients with PEG.
['Tsao|Chih-Cheng|CC|', 'Lee|Shih-Yu|SY|', 'Chang|Wei-Kuo|WK|', 'Lin|Kuen-Tze|KT|', 'Hsu|Sheng-Der|SD|', 'Tsai|Chen-Liang|CL|', 'Lin|Chun-Shu|CS|']
D000368:Aged D016208:Databases, Factual D004724:Endoscopy D005260:Female D005774:Gastrostomy D006801:Humans D008297:Male D008875:Middle Aged D012042:Registries D012189:Retrospective Studies D012307:Risk Factors D013270:Stomach D013274:Stomach Neoplasms D013624:Taiwan
Gastric cancer Percutaneous endoscopic gastrostomy Epidemiology NHIRD