Which malignancies are associated with pernicious anemia?

Updated: Feb 18, 2019
  • Author: Srikanth Nagalla, MD, MS, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Although vitamin B12 therapy resolves the anemia, it does not cure the atrophic gastritis, which can progress to gastric cancer. [7] The incidence of gastric adenocarcinoma is 2- to 3-fold greater in patients with pernicious anemia than in the general population of the same age. Presently, periodic gastroscopy and/or barium roentgenographic studies are not advocated in patients with treated pernicious anemia who are asymptomatic, because such screening has not been demonstrated to prolong lifespan.

A population-based, case-control study using the Surveillance, Epidemiology, and End Results (SEER)–Medicare database found that elderly persons with pernicious anemia were not only at significantly increased risk for noncardia gastric adenocarcinoma (odds ratio [OR] 2.18) and gastric carcinoid tumors (OR, 11.43), they were also at increased risk for the following [7] :

  • Tonsillar cancer (OR, 2.00)
  • Hypopharyngeal cancer (OR, 1.92)
  • Esophageal squamous cell carcinoma (OR, 2.12)
  • Small intestinal cancer (OR, 1.63)
  • Liver cancer (OR, 1.49)
  • Myeloma (OR, 1.55)
  • Acute myeloid leukemia (OR, 1.68)
  • Myelodysplastic syndrome (OR, 2.87)

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