Geographical Variance in the Risk of Gastric Stump Cancer: No Increased Risk in Japan?

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Abstract
Geographical differences may exist in the risk of gastric stump cancer. Therefore, we performed meta‐analysis of literature reports in Japan (n=3), the USA (n=4), and Europe (n = 20) on the risk of postgastrectomy cancer. The weighted mean relative risk of stump cancer in Japan was 0.28, 95% confidence limits 0.21–0.38 as compared to 1.53, 95% confidence limits 0.98–2.41 in the USA and 1.66, 95% confidence limits 1.55–1.79 in Europe. Thus, the risk of gastric cancer in the postgastrectomy patient seems decreased in Japan and is significantly less than in the USA or Europe, where an increased risk exists. Since there is a high risk of gastric cancer of the intact stomach in Japan, the discovery of a low cancer risk in the gastric stump may provide evidence that these gastric cancers are two different entities.