Association of Helicobacter pylori infection and diet on the risk of gastric cancer: a case-control study in Hawaii.

Epplein M, Nomura AM, Hankin JH, Blaser MJ, Perez-Perez G, Stemmermann GN, Wilkens LR, Kolonel LN
Cancer Causes Control. 2008 19 (8): 869-77

PMID: 18369531 · PMCID: PMC2799111 · DOI:10.1007/s10552-008-9149-2

OBJECTIVE - The risk factors most strongly associated with gastric cancer are the gastric bacteria Helicobacter pylori and diet. Utilizing data from a case-control study among residents in Hawaii, we examined the association of diet, presence of H. pylori, and non-cardia gastric cancer risk.

METHODS - Serum taken at diagnosis for cases (n = 212) and at interview for controls (n = 336) was assayed for IgG antibodies to H. pylori group antigens and to a recombinant fragment of the cytotoxin-associated antigen A (CagA) protein, and subjects completed food frequency questionnaires. Risk measures were calculated using logistic regression. The likelihood ratio test was used to assess interactions.

RESULTS - Inverse associations were found between gastric cancer risk and increasing intake of several micronutrients and vegetables among all individuals. For H. pylori/CagA-positive subjects, significant trends were present for total, green, and yellow vegetables, while a significant trend was present only for yellow vegetables among H. pylori/CagA-negative individuals. For intestinal gastric cancer, there was a suggestion that intake of vegetables, especially cruciferous vegetables, had a stronger protective effect for the H. pylori/CagA-positive group.

CONCLUSIONS - Diet may play a greater role in the etiology of non-cardia gastric cancer among individuals with evidence of H. pylori infection than among those without.

MeSH Terms (20)

Adult Aged Aged, 80 and over Antigens, Bacterial Bacterial Proteins Cardia Case-Control Studies Diet Ethnic Groups Female Hawaii Helicobacter Infections Helicobacter pylori Humans Immunoglobulin G Male Middle Aged Risk Factors SEER Program Stomach Neoplasms

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