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Abstract
An association between appendectomy and subsequent gastrointestinal (GI) cancer development has been postulated, although the evidence is limited and inconsistent. To provide clarification, we investigated the link between appendectomy and GI cancers in a large nationwide appendectomy cohort. This cohort was derived from the claims database of the National Health Insurance Service in South Korea and comprised 158,101 patients who had undergone appendectomy between 2007 and 2014. A comparison cohort of 474,303 subjects without appendectomy was selected after 1:3 matching by age and sex. The incidence of GI cancers after appendectomy was observed, and risk factors for GI cancers were determined by using a multivariable-adjusted proportional hazards model. Appendectomy did not significantly increase the incidence of GI cancers in the overall population (1.529 and 1.557 per 1000 person-years in the non-appendectomy and appendectomy cohorts, respectively). However, appendectomy significantly increased the incidence of GI cancers in subgroups consisting of elderly (≥ 60 years) patients (adjusted HR, 1.102; 95% confidence interval, 1.011–1.201; p = 0.028) or women (adjusted HR, 1.180; 95% confidence interval, 1.066–1.306; p = 0.001).
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1 The Catholic University of Korea, Division of Coloproctology, Department of Surgery, College of Medicine, Uijeongbu St. Mary’s Hospital, Uijeongbu-si, Republic of Korea (GRID:grid.411947.e) (ISNI:0000 0004 0470 4224)
2 Catholic University of Korea, Department of Medical Statistics, College of Medicine, Seoul, Republic of Korea (GRID:grid.411947.e) (ISNI:0000 0004 0470 4224)
3 Soongsil University, Department of Statistics and Actuarial Science, Seoul, Republic of Korea (GRID:grid.263765.3) (ISNI:0000 0004 0533 3568)