胃肠内镜切除（C-ER）在日本由于结直肠癌（CRC）的增加而得到广泛传播。C-ER后有时会发生胃癌（GC）。我们旨在使用大样本数据分析C-ER后GC的情况。我们回顾性地使用了2005年至2018年商业匿名的医疗保险索赔数据，提取了62,392名接受C-ER的≥50岁的患者。分析了GC的发病率和危险因素。此外，将受试者分为≥2 cm组和<2 cm组，并分析了GC的风险。中位年龄（范围）为58（50-75）岁，GC的总体发病率为0.68％（423/62,392）。多变量分析显示，GC的显著危险因素[奥比率（OR），95％置信区间（CI）]为肠道病变大小≥2 cm（1.75，1.24-2.47，p=0.002），年龄≥65岁（1.65，1.31-2.07，p<0.001），男性（2.35，1.76-3.13，p<0.001），糖尿病（1.40，1.02-1.92，p=0.035），肝病（1.54，1.06-2.24，p=0.025），幽门螺杆菌感染（2.10，1.65-2.67，p<0.001），慢性萎缩性胃炎（1.58，1.14-2.18，p=0.006）和CRC（1.72，1.10-2.68，p=0.017）。≥2 cm组的GC发病率显著高于<2 cm组（1.17％和0.65％，p<0.001）。根据显著危险因素的数量，与没有危险因素的患者相比，GC的发病率和危险比率（95％CI）在具有1-2个危险因素的患者中分别为0.64％和3.64（2.20-6.02），在具有≥3个危险因素的患者中分别为1.95％和11.17（6.57-19.00）。使用大样本数据，可以调查C-ER后≥2 cm的结直肠良性病变的GC的危险因素。© 2023年。日本胃肠病学会。

Colorectal endoscopic resection (C-ER) is spreading due to the increase of colorectal cancer (CRC) in Japan. Gastric cancer (GC) sometimes occurs after C-ER. We aimed to analyze the status of GC after C-ER using large-scale data.We retrospectively used commercially anonymized health insurance claims data of 5.71 million patients from 2005 to 2018, and extracted 62,392 patients ≥ 50 years old who received C-ER. The incidence and risk factors of GC were analyzed. Additionally, subjects were divided into ≥ 2 cm group and < 2 cm group and risks of GC were analyzed.The median age (range) was 58 (50-75) years and the overall rate of GC was 0.68% (423/62,392). Multivariate analysis showed that significant risk factors for GC [odds rates (OR), 95% confidence interval (CI)] were colorectal lesion size ≥ 2 cm (1.75, 1.24-2.47, p = 0.002), age ≥ 65 y.o. (1.65, 1.31-2.07, p < 0.001), male (2.35, 1. 76-3.13, p < 0.001), diabetes mellitus (1.40, 1.02-1.92, p = 0.035), liver disease (1.54, 1.06-2.24, p = 0.025), Helicobacter pylori infection (2.10, 1.65-2.67, p < 0.001), chronic atrophic gastritis (1.58, 1.14-2.18, p = 0.006), and CRC (1.72, 1.10-2.68, p = 0.017). The rate of GC in the ≥ 2 cm was significantly higher than that in < 2 cm groups (1.17% and 0.65%, p < 0.001). According to the number of significant risk factors, the rates of GC and the hazard ratios of GC (95%CI) were 0.64% and 3.64 (2.20-6.02) and 1.95% and 11.17 (6.57-19.00) for patient with 1-2 and ≥ 3 risk factors, compared with patients without risk factors.Using large-scale data, risk factors for GC, including colorecal lesions ≥ 2 cm after C-ER could be investigated.© 2023. Japanese Society of Gastroenterology.