Gastric Cancer after Gastric Operations

To the Editor: Schafer et al. (Nov. 17 issue) 1 conclude that "gastric cancer is no more common among patients with prior gastric surgery for peptic-ulcer disease than among members of the population at large." We are uncomfortable with this conclusion. Among patients treated surgically for ulcers, only those who had no evidence of gastric carcinoma for five years were included in the study. This is a standard precaution to rule out the presence of an unsuspected carcinoma at the time of surgery. Others who have imposed this restriction necessarily excluded patients who were lost to follow-up or died within five . . .