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Risk of gastric cancer among smokers infected with Helicobacter pylori
Author(s) -
Brenner Hermann,
Arndt Voler,
Bode Günter,
Stegmaier Christa,
Ziegler Hartwig,
Stümer Til
Publication year - 2002
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.10201
Subject(s) - caga , helicobacter pylori , cancer , medicine , gastroenterology , confounding , risk factor , spirillaceae , population , antibody , case control study , relative risk , immunology , gastritis , biology , confidence interval , environmental health , virulence , biochemistry , gene
Infection with the gastric bacterium Helicobacter pylori (in particular infection with CagA‐positive strains) and smoking have been identified as risk factors for the development of gastric cancer. Both risk factors are typically acquired early in life and prevail over decades if not for life. We assessed the individual and joint impact of both risk factors on gastric cancer risk in a population‐based case‐control study from Germany including 71 patients with histologically verified gastric cancer and 363 patients with colorectal cancer who served as controls. Information on smoking and potential confounding factors was collected by standardized interviews. H. pylori infection was measured serologically by immunoglobulin G antibody titers against H. pylori . In addition, antibodies against the CagA antigen were determined by Western blot. Twenty‐seven percent of cases compared with 15% of controls were smokers, and 43% of cases compared with 23% of controls were infected with CagA‐positive H. pylori strains. After control for potential confounders, the relative risk of gastric cancer was 2.6 (95% CI 1.2‐5.7) for nonsmoking subjects with CagA‐positive H. pylori infections and 7.2 (95% CI 2.2–23.6) for smoking subjects with CagA‐positive H. pylori infections compared with subjects without these risk factors. The corresponding relative risks for noncardia gastric cancer were 6.1 ( 95% CI 2.3–16.5) and 16.6 (95% CI 4.3–64.2). We conclude that smoking subjects with CagA‐positive H. pylori infections have a strongly increased risk of gastric cancer and may be an important group for targeting efforts of prevention and early detection. © 2002 Wiley‐Liss, Inc.