Meira Epplein
Faculty Member
Last active: 5/5/2016

Race, African ancestry, and Helicobacter pylori infection in a low-income United States population.

Epplein M, Signorello LB, Zheng W, Peek RM, Michel A, Williams SM, Pawlita M, Correa P, Cai Q, Blot WJ
Cancer Epidemiol Biomarkers Prev. 2011 20 (5): 826-34

PMID: 21357376 · PMCID: PMC3089670 · DOI:10.1158/1055-9965.EPI-10-1258

BACKGROUND - Gastric cancer incidence in African Americans is twice that of whites, and differing prevalence of Helicobacter pylori strain-specific isolates may help explain the disparity.

METHODS - Serum levels of antibodies to each of 15 H. pylori proteins were assessed using multiplex serology for a sample of 689 African American and white participants from the Southern Community Cohort Study. African and European admixture was estimated using a panel of 276 ancestry genetic markers, with "low," "medium," and "high" categories of African ancestry defined as <85%, 85% to 95%, and ≥95%.

RESULTS - The majority (79%) of our study population were sero-positive for H. pylori. African American race was associated with a two- to sixfold increased odds for sero-positivity to eight H. pylori proteins, including the cancer-associated virulence constituents CagA [odds ratio (OR), 6.4; 95% CI, 4.5-9.1], and VacA (OR, 2.3; 95% CI, 1.5-3.5). Compared to whites, African Americans of low, medium, and high African ancestry had 1.6-, 4.1-, and 5.2-fold increased odds of sero-positivity to H. pylori, primarily related to CagA sero-positive strains, for which increasing African ancestry led to 2.5-, 9.6-, and 13.1-fold increased odds. Among African Americans alone, compared to those of low African ancestry, African Americans of medium and high African ancestry had 2.5- and 3.4-fold increased odds of sero-positivity to H. pylori, and 3.5- and 4.9-fold increased odds of CagA sero-positive H. pylori strains.

CONCLUSIONS - Host genetic variation and/or lifestyle factors associated with African ancestry contribute to the likelihood of infection with H. pylori, particularly its virulent strains, in this low-income U.S. southern population.

IMPACT - Our findings that low-income African Americans of high African ancestry have a particularly high prevalence of antibodies against H. pylori provides a framework for further research into better detection and prevention of gastric cancer in this population.

©2011 AACR.

MeSH Terms (18)

Adult African Continental Ancestry Group Aged Cohort Studies European Continental Ancestry Group Female Helicobacter Infections Helicobacter pylori Humans Incidence Male Middle Aged Poverty Prevalence Prospective Studies Risk Factors Stomach Neoplasms United States

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