People who have had all or part of their stomach removed appear to have an increased risk of later developing cancer of the larynx, doctors in Italy report.

Therefore, “periodic laryngeal examination should be considered in long-term follow-up of patients with gastric surgery,” Dr. Giovanni Cammarota, at the Catholic University of Medicine and Surgery in Rome, and his associates write in the Annals of Surgery.

Cammarota’s group previously reported a study showing a predisposition to laryngeal cancer in patients who had undergone gastric excision. They theorized that reflux of intestinal contents may damage the lining of the larynx, leading to malignancy.

To investigate further, the team conducted a look-back study of 828 patients with laryngeal cancer, comparing them with a “control” group of patients treated for a heart attack.

Eight percent of the laryngeal cancer group but less than two percent of the control group had previously undergone stomach surgery, in each case to treat peptic ulcers.

After factoring in demographics, alcohol consumption and smoking, previous surgery of the stomach increased the likelihood of having laryngeal cancer more than fourfold.

SOURCE: Annals of Surgery, November 2004.