Lee et al developed a nomogram for predicting gastric cancer associated with peptic ulcer disease. This can help to identify a patient who should be screened for the disease. The authors are from multiple institutions in Taiwan.
Patient selection: adult with peptic ulcer disease in Taiwan
Outcome: 2-year risk of gastric cancer
Parameters:
(1) age
(2) gender
(3) ulcer sites
(4) peptic ulcer complications
(5) H. pylori eradication
(6) duration of NSAID use in the 3 months before hospitalization
(7) upper GI follow-up indicated
Age Range
Points
40 to 65
(-0.06135 * ((age)^2)) + (8.209 * (age)) -230.5
65 to 85
(-0.07029 * ((age)^2)) + (12.16 * (age)) - 450.2
85 to 110
(0.2465 * (age)) + 54.1
Parameter
Finding
Points
gender
female
0
male
16.8
peptic ulcer sites
duodenum
0
gastric and duodenum
38
gastric
75.6
complications
no
0
yes
20.4
H. pylori eradicated
no
23.5
yes
0
NSAID duration
never used
85.3
1 month
57
2 months
28.5
3 months
0
follow-up indicated
no
0
yes
100
The NSAID duration can be represented as:
points for NSAIDS =
= (85.36 - (28.44 * (duration in months))
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 402.8
• The higher the score the greater the risk of gastric cancer.
