The Association of Lactose Intolerance With Colon and Gastric Cancers: Friend or Foe?

Mohammad Maysara Asfari; Osama Hamid; Muhammad Talal Sarmini; Katherine Kendrick; Lakshmi Priyanka Pappoppula; Humberto Sifuentes; Subbaramiah Sridhar

doi:10.7759/cureus.24713

The Association of Lactose Intolerance With Colon and Gastric Cancers: Friend or Foe?

Cureus. 2022 May 3;14(5):e24713. doi: 10.7759/cureus.24713. eCollection 2022 May.

Authors

Mohammad Maysara Asfari¹, Osama Hamid², Muhammad Talal Sarmini¹, Katherine Kendrick³, Lakshmi Priyanka Pappoppula⁴, Humberto Sifuentes⁴, Subbaramiah Sridhar⁴

Affiliations

¹ Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, USA.
² Department of Hospital Medicine, Cleveland Clinic, Cleveland, USA.
³ Department of Gastroenterology and Hepatology, University of South Carolina, Greenville, USA.
⁴ Department of Gastroenterology and Hepatology, Augusta University Medical College of Georgia, Augusta, USA.

Abstract

Background: Lactose intolerance (LI) appears usually in later ages when the lactase enzyme becomes deficient or absent in the small intestine. Conflicting results have been reported in the literature about the association of lactose intolerance with various gastrointestinal malignancies. Hence, our aim was to study the association between LI, colon cancer (CCa), and gastric cancer (GC) using a large database.

Methods: A cross-sectional study was performed using the National Inpatient Sample (NIS) database between 2004 and 2014. We identified adult patients (18-90 years) who were diagnosed with LI (study group) using appropriate International Classification of Diseases, Ninth Revision (ICD-9) codes. The control group comprised patients who did not have a diagnosis of LI. We identified the diagnosis of CCa and GC in both study and control groups using the ICD-9 codes. Univariable and multivariable logistic regression analyses were performed to assess the association between LI, CCa, and GC.

Results: The total population comprised 71,360,501 patients, of which 57,909 (0.08%) were diagnosed with LI. LI patients were older (62 vs 51 years) with more females (61.5% vs 60.1%) and less African American patients (11.8% vs 14.3%) (p <0.0001 for all). In addition, LI patients had more smoking (12.4% vs 12%) and obesity (15% vs 8.9%). On the other hand, patients in the LI group had less alcohol use (3.8% vs 4.2%) (p <0.0001). After adjusting for the age, gender, race, smoking, alcohol, obesity, and inflammatory bowel disease, the LI group had a slightly lower rate of CCa (OR 0 .974, 95%CI 0.906-1.048, p = 0.486) and a lower rate of GC (OR: 0.993, 95%CI 0.924-1.068, p =0.853); however, the results were not statistically significant.

Conclusion: Patients with lactose intolerance may have a lower risk of colon and gastric cancer. However, these findings were not statistically significant. Further studies are needed to understand this association.

Keywords: colon cancer; gastric cancer; lactase; lactose intolerance; national inpatient sample.