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Pancreatic cancer

Gastric ulcers increase pancreatic cancer risk in men

New research shows that men with gastric ulcers are at an increased risk of pancreatic cancer, and that the presence of a duodenal ulcer is not associated with pancreatic cancer. “This suggests a potential mechanism linked to nitrosamine levels,” says Dominique Michaud, corresponding author from Imperial College London.

The etiology of pancreatic cancer is poorly understood. “Studies on the role of peptic ulcers in pancreatic carcinogenesis have been inconclusive,” remarks Michaud, “[and] some have hypothesized that inflammation and Helicobacter pylori may be implicated.” Gastric ulcers are associated with H. pylori gastritis in the corpus, low acid production and high N-nitrosamine levels whilst duodenal ulcers are associated with antrum-predominant H. pylori, high acid levels and low N-nitrosamine levels.

Bao and colleagues assessed data collected from a cohort of 51,529 male health professionals from across the USA. Between 1986 and 2004, data had been recorded every 2 years regarding participants' medical history, diet and lifestyle habits. The researchers used this information to investigate the association between pancreatic cancer and the presence of gastric or duodenal ulcers. They observed 274 cases of pancreatic cancer and found that men with gastric ulcers had an increased risk of pancreatic cancer compared with those men who had no history of peptic ulcers. In addition, no link was found between duodenal ulcers and risk of pancreatic cancer.

The investigators now plan to examine the link between bacteria, including H. pylori, and pancreatic cancer.


  1. Bao, Y. et al. History of peptic ulcer disease and pancreatic cancer risk in men. Gastroenterology 138, 541–549 (2010)

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Ray, K. Gastric ulcers increase pancreatic cancer risk in men. Nat Rev Gastroenterol Hepatol 7, 183 (2010).

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