The potential role of nontyphoidal salmonellosis in gastric cancer: a nationwide matched cohort study
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ORIGINAL ARTICLE
The potential role of nontyphoidal salmonellosis in gastric cancer: a nationwide matched cohort study Renin Chang1,2,3 · James Cheng‑Chung Wei4,5,6 · Mei‑Chen Lin7 · Yao‑Min Hung8,9,10 Received: 19 July 2020 / Accepted: 28 September 2020 © The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2020
Abstract Background The research is to explore the association between nontyphoidal salmonellosis (NTS) and subsequent gastric cancer. Methods We conducted a retrospective study by analyzing hospitalization dataset from the National Health Insurance Research Database in Taiwan. Patients aged 20 years and older with NTS (n = 9 097) admitted between January 1, 2000, and December 31, 2012, were enrolled and followed up until December 31, 2013. The primary outcome was the incidence of gastric cancer. Cox proportional hazards regression was used to estimate the risk of malignancy, accounting for the competing risk of death. In addition, we conducted a sensitivity analysis by propensity score matching and exclusion of malignancy within 1 year observation to minimize measurable confounding and protopathic bias. Negative controls were applied to examine the presence of possible unmeasured confounders in the study. Results The study included 18 194 patients (9097 in each NTS and non-NTS group). The median follow-up time was 7 years. The incidence density rate of gastric cancer was 0.72 per 1000 person-years for the NTS group and 0.40 per 1000 personyears for the non-NTS group. The NTS group had a modestly higher risk of gastric cancer (aHR, 2.02; 95% CI 1.18–3.45) than the non-NTS group. The sensitivity analyses revealed consistent results. Conclusions Patients with NTS are associated with increased risk of subsequent gastric cancer compared with non-NTS patients. Future research is needed to examine whether NTS is parallel, reactive or causative to gastric cancer. Keywords Nontyphoidal salmonellosis · Gastric cancer · Cohort Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10120-020-01132-x) contains supplementary material, which is available to authorized users. * Yao‑Min Hung [email protected]
5
Institute of Medicine, Chung Shan Medical University, Taichung 40203, Taiwan
Renin Chang [email protected]
6
Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
James Cheng‑Chung Wei [email protected]
7
Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan
Mei‑Chen Lin [email protected]
8
Department of Internal Medicine, Kaohsiung Municipal United Hospital, 976, Jhong‑hua 1st Rd, Gu‑shan Dist., Kaohsiung 80457, Taiwan
1
Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
9
2
Department of Recreation Sports Management, Tajen University, Pingtung, Taiwan
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
10
3
Institute of Biotechnology and Chemical Engine
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