RISK-FACTORS FOR ADENOCARCINOMAS AND MALIGNANT CARCINOIDS OF THE SMALL-INTESTINE - PRELIMINARY FINDINGS

Although the small intestine contains 75% of the mucosal surface of th e gastrointestinal tract, it is the site of only 2% as many malignanci es as the large bowel. The association of Crohn's disease with small i ntestine adenocarcinoma is well known, but the analytic epidemiology o f small intestine malignancies has not received much attention. We rev iewed the medical records of 19 patients with adenocarcinoma and 17 wi th malignant carcinoids identified from the Columbia-Presbyterian Medi cal Center Tumor Registry in the years 1980-1987. These were compared with 52 controls with nonmalignant conditions from the same time perio d. Three adenocarcinoma patients but no carcinoid patients or controls had previous Crohn's disease (P < 0.004). Three adenocarcinomas and t hree carcinoids, but not controls, had previous cholecystectomy (P < 0 .004). Previous peptic ulcer disease was recorded for two patients wit h adenocarcinoma and three with carcinoid but no controls (P < 0.02, P < 0.0002). The age and sex adjusted odds ratio for cigarette smoking was 4.6 (95% confidence interval, 1.0-20.7) for adenocarcinomas and 4. 2 (0.8-22.4) for carcinoids. The adjusted odds ratio for alcohol consu mption was 4.0 (1.0-15.9) for adenocarcinomas and 3.1 (0.7-13.9) for c arcinoids. Further studies are warranted to confirm these associations and to identify potential protective factors in the small intestine.