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Helicobacter pylori Infection and Risk of Cardia Cancer and Non-Cardia Gastric Cancer: A Nested Case-Control Study

Background: Helicobacter pylori infection is an established risk factor for gastric adenocarcinoma. Potential confounding by socioeconomic factors has not been adequately assessed, and the magnitude of the relative risk in relation to gastric subsites, morphologic subtypes, sex, age, and follow-up t...

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Published in:Scandinavian journal of gastroenterology 1999, Vol.34 (4), p.353-360
Main Authors: HANSEN, S, MELBY, K. K, AASE, S, JELLUM, E, VOLLSET, S. E
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container_title Scandinavian journal of gastroenterology
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creator HANSEN, S
MELBY, K. K
AASE, S
JELLUM, E
VOLLSET, S. E
description Background: Helicobacter pylori infection is an established risk factor for gastric adenocarcinoma. Potential confounding by socioeconomic factors has not been adequately assessed, and the magnitude of the relative risk in relation to gastric subsites, morphologic subtypes, sex, age, and follow-up time need further study. Methods: We conducted a serologic case-control study nested within the Norwegian JANUS cohort. Between 1972 and 1986 serum was collected from 101,601 subjects who were followed up with regard to cancer development through 1992. Results: Among 208 gastric adenocarcinoma cases, we found a strong positive association between H. pylori infection and non-cardia gastric cancer (odds ratio (OR), 5.15; 95% confidence interval (CI), 2.83-9.37), and a statistically significant negative association with cardia cancer (OR, 0.40; 95% CI, 0.20-0.77). Adjustment for socioeconomic factors and smoking did not materially alter the effect estimates. The association between the infection and non-cardia cancer was stronger for tumors distal to the angulus and tended to be stronger in women than in men. The results were similar across Laurén morphologic subtypes. Conclusions: These results strengthen the evidence of H. pylori infection as a risk factor in non-cardia gastric cancer. A negative association with H. pylori infection was found for cardia cancer.
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Results: Among 208 gastric adenocarcinoma cases, we found a strong positive association between H. pylori infection and non-cardia gastric cancer (odds ratio (OR), 5.15; 95% confidence interval (CI), 2.83-9.37), and a statistically significant negative association with cardia cancer (OR, 0.40; 95% CI, 0.20-0.77). Adjustment for socioeconomic factors and smoking did not materially alter the effect estimates. The association between the infection and non-cardia cancer was stronger for tumors distal to the angulus and tended to be stronger in women than in men. The results were similar across Laurén morphologic subtypes. Conclusions: These results strengthen the evidence of H. pylori infection as a risk factor in non-cardia gastric cancer. 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Results: Among 208 gastric adenocarcinoma cases, we found a strong positive association between H. pylori infection and non-cardia gastric cancer (odds ratio (OR), 5.15; 95% confidence interval (CI), 2.83-9.37), and a statistically significant negative association with cardia cancer (OR, 0.40; 95% CI, 0.20-0.77). Adjustment for socioeconomic factors and smoking did not materially alter the effect estimates. The association between the infection and non-cardia cancer was stronger for tumors distal to the angulus and tended to be stronger in women than in men. The results were similar across Laurén morphologic subtypes. Conclusions: These results strengthen the evidence of H. pylori infection as a risk factor in non-cardia gastric cancer. 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subjects Adenocarcinoma - epidemiology
Adenocarcinoma - microbiology
Biological and medical sciences
Cardia
Case-Control Studies
Female
Gastroenterology. Liver. Pancreas. Abdomen
Helicobacter Infections - complications
Helicobacter Infections - epidemiology
Helicobacter pylori
Humans
Male
Medical sciences
Middle Aged
Norway - epidemiology
Risk Factors
Smoking - epidemiology
Socioeconomic Factors
Stomach Neoplasms - epidemiology
Stomach Neoplasms - microbiology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tumors
title Helicobacter pylori Infection and Risk of Cardia Cancer and Non-Cardia Gastric Cancer: A Nested Case-Control Study
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