Mortality From Gastric Cancer and Other Causes After Medical or Surgical Treatment for Gastric Ulcer2

This long-term, follow-up study was undertaken to determine whether patients with benign gastric ulcer have an increased risk of developing gastric cancer or other selected causes of death. Patients (1,928) with a diagnosis of benign gastric ulcer treated in 1 of 9 medical institutions in the Boston area during 1945–55 inclusive, were followed for 8–18 years until December 31, 1963. The follow-up was made primarily by search of Massachusetts death certificates. More direct follow-up of a 10% random sample indicated the degree of follow-up obtained by death certificate search to be satisfactory for this purpose. The mortality of the patients was compared with the expected mortality estimated from the mortality experience of the general population of comparable age and sex. Following the first year after entry into study, the patients had virtually the same mortality as that of the general population. A lower mortality from arteriosclerotic heart disease was noted. In the group treated medically (1,038 patients), an excess mortality was observed for liver cirrhosis and suicide. This group had no excess mortality from gastric cancer 5 years and more after entry into the study, which does not support a hypothesis of frequent malignant change of benign gastric ulcer. The group treated surgically (890 patients) showed no deviation from the normal expectancy of death from gastric cancer.