| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© The Author 2006. Published by Oxford University Press.
ARTICLE |
Opposing Risks of Gastric Cardia and Noncardia Gastric Adenocarcinomas Associated With Helicobacter pylori Seropositivity
Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (FK, SMD, CCA, DA, PRT); Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (FK, CJN); Departments of Medicine and Microbiology, New York University School of Medicine, New York, NY (MJB, GIPP); Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland (PP, JV)
Correspondence to: Farin Kamangar, MD, PhD, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Rm. 3034, Bethesda, MD 20892-7232 (e-mail: Kamangaf{at}mail.nih.gov).
Background: Colonization with Helicobacter pylori is a risk factor for gastric adenocarcinoma, but the magnitude of this association and its relationship to anatomic location of the cancer, duration of follow-up, age at diagnosis, histologic subtype, and H. pylori strain differences are less clear. We conducted a prospective nested case–control study of H. pylori serology to address these questions. Methods: Case and control subjects were selected from the 29 133 50- to 69-year-old males recruited into the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. At baseline, detailed demographic data and a serum sample were collected. From 1985 to 1999, 243 incident cases of gastric adenocarcinoma were diagnosed in cohort members. Serum samples from 234 case subjects (173 with noncardia gastric cancers and 61 with gastric cardia cancers) and 234 age-matched control subjects were assayed for antibodies against H. pylori whole-cell and CagA antigens. We fit conditional logistic regression models to estimate the unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association of H. pylori seropositivity, defined as seropositivity to either whole-cell or CagA antigens, with noncardia gastric and gastric cardia cancers. All statistical tests were two-sided. Results: H. pylori seropositivity was strongly associated with the risk of noncardia gastric cancer (adjusted OR = 7.9, 95% CI = 3.0 to 20.9) but was inversely associated with the risk of gastric cardia cancer (adjusted OR = 0.31, 95% CI = 0.11 to 0.89). H. pylori seropositivity rates did not vary statistically significantly by length of follow-up, age at diagnosis, or histologic subtype. A calculation of rates showed that the absolute risks of noncardia gastric and cardia gastric adenocarcinomas in the H. pylori–positive participants of this cohort would be 63 and 12 per 100 000 person-years, respectively, whereas corresponding rates in H. pylori–negative participants would be 8 and 37 per 100 000 person-years, respectively. Conclusion: H. pylori is a strong risk factor for noncardia gastric cancer but is inversely associated with the risk of gastric cardia cancer. These findings bolster the hypothesis that decreasing H. pylori prevalence during the past century may have contributed to lower rates of noncardia cancer and higher rates of cardia cancer in Western countries.
CiteULike 
Connotea 
Del.icio.us What's this?
Editorial about this Article
- Helicobacter pylori Infection: Mainly Foe but Also Friend?
- Olof Nyrén and William J. Blot
J Natl Cancer Inst 2006 98: 1432-1434.[Extract] [Full Text] [PDF]
This article has been cited by other articles:
|
|
 |
|
  S. Takaishi, T. Okumura, and T. C. Wang Gastric Cancer Stem Cells J. Clin. Oncol., June 10, 2008; 26(17): 2876 - 2882. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D A Corley, A Kubo, T R Levin, G Block, L Habel, W Zhao, P Leighton, G Rumore, C Quesenberry, P Buffler, et al. Helicobacter pylori infection and the risk of Barrett's oesophagus: a community-based study Gut, June 1, 2008; 57(6): 727 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M H Derakhshan, R Malekzadeh, H Watabe, A Yazdanbod, V Fyfe, A Kazemi, N Rakhshani, R Didevar, M Sotoudeh, A A Zolfeghari, et al. Combination of gastric atrophy, reflux symptoms and histological subtype indicates two distinct aetiologies of gastric cardia cancer Gut, March 1, 2008; 57(3): 298 - 305. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Hansen, S. E. Vollset, M. H Derakhshan, V. Fyfe, K. K Melby, S. Aase, E. Jellum, and K. E L McColl Two distinct aetiologies of cardia cancer; evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori status Gut, July 1, 2007; 56(7): 918 - 925. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Gastric Carcinomas Associated with H. pylori Infection Journal Watch Oncology and Hematology, December 4, 2006; 2006(1204): 1 - 1. [Full Text]
|
|
|
|
 |
|
 O. Nyren and W. J. Blot Helicobacter pylori Infection: Mainly Foe but Also Friend? J Natl Cancer Inst, October 18, 2006; 98(20): 1432 - 1434. [Full Text] [PDF]
|
|