CagA+ Helicobacter pylori infection and gastric cancer risk in the EPIC-EURGAST study.

TitleCagA+ Helicobacter pylori infection and gastric cancer risk in the EPIC-EURGAST study.
Publication TypeJournal Article
Year of Publication2007
AuthorsPalli, D, Masala, G, del Giudice, G, Plebani, M, Basso, D, Berti, D, Numans, ME, Numans, ME, Ceroti, M, Peeters, PHM, H de Mesquita, BBueno, Büchner, FL, Clavel-Chapelon, F, Boutron-Ruault, M-C, Krogh, V, Saieva, C, Vineis, P, Panico, S, Tumino, R, Nyrén, O, Simán, H, Berglund, G, Hallmans, G, Sánchez, M-J, Larrañaga, N, Barricarte, A, Navarro, C, Quirós, JR, Key, T, Allen, N, Bingham, S, Khaw, KTee, Boeing, H, Weikert, C, Linseisen, J, Nagel, G, Overvad, K, Thomsen, RW, Tjonneland, A, Olsen, A, Trichoupoulou, A, Trichopoulos, D, Arvaniti, A, Pera, G, Kaaks, R, Jenab, M, Ferrari, P, Nesi, G, Carneiro, F, Riboli, E, González, CA
JournalInt J Cancer
Volume120
Issue4
Pagination859-67
Date Published2007 Feb 15
ISSN0020-7136
KeywordsAdenocarcinoma, Antibodies, Bacterial, Antigens, Bacterial, Bacterial Proteins, Cardia, Case-Control Studies, Cohort Studies, Helicobacter Infections, Helicobacter pylori, Humans, International Agencies, Male, Middle Aged, Prevalence, Prospective Studies, Risk Assessment, Risk Factors, Seroepidemiologic Studies, Stomach Neoplasms, Time Factors
Abstract

Helicobacter pylori (H. pylori), atrophic gastritis, dietary and life-style factors have been associated with gastric cancer (GC). These factors have been evaluated in a large case-control study nested in the European Prospective Investigation into Cancer and Nutrition carried out in 9 countries, including the Mediterranean area. Participants, enrolled in 1992-1998, provided life-style and dietary information and a blood sample (360,000; mean follow-up: 6.1 years). For 233 GC cases diagnosed after enrolment and their 910 controls individually-matched by center, gender, age and blood donation date H. pylori antibodies (antilysate and antiCagA) and plasma Pepsinogen A (PGA) were measured by ELISA methods. Severe chronic atrophic gastritis (SCAG) was defined as PGA circulating levels <22 microg/l. Overall, in a conditional logistic regression analysis adjusted for education, smoke, weight and consumption of total vegetables, fruit, red and preserved meat, H. pylori seropositivity was associated with GC risk. Subjects showing only antibodies anti-H. pylori lysate, however, were not at increased risk, while those with antiCagA antibodies had a 3.4-fold increased risk. Overall, the odds ratio associated with SCAG was 3.3 (95% CI 2.2-5.2). According to site, the risk of noncardia GC associated with CagA seropositivity showed a further increase (OR 6.5; 95% CI 3.3-12.6); on the other hand, a ten-fold increased risk of cardia GC was associated with SCAG (OR 11.0; 95% CI 3.0-40.9). These results support the causal relationship between H. pylori CagA+ strains infection, and GC in these European populations even after taking into account dietary habits. This association was limited to distal GC, while serologically defined SCAG was strongly associated with cardia GC, thus suggesting a divergent risk pattern for these 2 sites.

DOI10.1002/ijc.22435
Alternate JournalInt. J. Cancer
Citation Key10.1002/ijc.22435
PubMed ID17131317
Grant ListG0401527 / / Medical Research Council / United Kingdom
/ / Wellcome Trust / United Kingdom