Original Article Association of ampullary and colorectal malignancies Ananya Das, M.D. 1 *, Alfred I. Neugut, M.D., Ph.D. 2, Gregory S. Cooper, M.D. 1, Amitabh Chak, M.D. 1 1Division of Gastroenterology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio 2Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York email: Ananya Das (ananya.das@med.va.gov) *Correspondence to Ananya Das, Wearn II, Division of Gastroenterology, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106 Fax: (216) 844-8011 Dr. Neugut is the recipient of a K05 award from the National Cancer Institute (CA89155). Abstract BACKGROUND Because of the similarities in terms of carcinogenesis and natural history between cancer of the ampulla of Vater and colorectal cancer, the authors examined whether ampullary and colorectal malignancies occur in the same individuals at increased rates. METHODS We used data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute for the period from January 1973 through December 1999. Person-years of follow-up for patients with ampullary (or colorectal) cancer were used to calculate the expected number of cases of colorectal (or ampullary) cancer as a second primary malignancy. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated using Byar limits and assuming a Poisson distribution. RESULTS The authors identified 2043 white patients with ampullary cancer who were included in the SEER registry between 1973 and 1999. Over an aggregate 5674 person-years of follow-up, 30 patients, compared with an expected 14, developed colorectal cancer, yielding an overall SIR of 2.14 (95% CI, 1.45-3.06). Similarly, 57 of 262,066 white patients with colorectal cancer developed ampullary cancer over an aggregate 1,270,255 person-years of follow-up, yielding an SIR of 2.18 (95% CI, 1.69-2.85). CONCLUSIONS Patients with ampullary cancer are at increased risk for a second primary colorectal malignancy, and patients with colorectal cancer are at increased risk for a second primary ampullary malignancy. These findings suggest that ampullary and colorectal malignancies share common environmental and/or genetic risk factors. Cancer, 2/04 Volume 100, Issue 3 , Pages 524 - 530 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.