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Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts.
Gut 2001; 49(3):347-53Gut

Abstract

BACKGROUND

The magnitude of the association between Helicobacter pylori and incidence of gastric cancer is unclear. H pylori infection and the circulating antibody response can be lost with development of cancer; thus retrospective studies are subject to bias resulting from classification of cases as H pylori negative when they were infected in the past.

AIMS

To combine data from all case control studies nested within prospective cohorts to assess more reliably the relative risk of gastric cancer associated with H pylori infection. To investigate variation in relative risk by age, sex, cancer type and subsite, and interval between blood sampling and cancer diagnosis.

METHODS

Studies were eligible if blood samples for H pylori serology were collected before diagnosis of gastric cancer in cases. Identified published studies and two unpublished studies were included. Individual subject data were obtained for each. Matched odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for the association between H pylori and gastric cancer.

RESULTS

Twelve studies with 1228 gastric cancer cases were considered. The association with H pylori was restricted to non-cardia cancers (OR 3.0; 95% CI 2.3-3.8) and was stronger when blood samples for H pylori serology were collected 10+ years before cancer diagnosis (5.9; 3.4-10.3). H pylori infection was not associated with an altered overall risk of cardia cancer (1.0; 0.7-1.4).

CONCLUSIONS

These results suggest that 5.9 is the best estimate of the relative risk of non-cardia cancer associated with H pylori infection and that H pylori does not increase the risk of cardia cancer. They also support the idea that when H pylori status is assessed close to cancer diagnosis, the magnitude of the non-cardia association may be underestimated.

Authors

No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

11511555

Citation

Helicobacter and Cancer Collaborative Group. "Gastric Cancer and Helicobacter Pylori: a Combined Analysis of 12 Case Control Studies Nested Within Prospective Cohorts." Gut, vol. 49, no. 3, 2001, pp. 347-53.
Helicobacter and Cancer Collaborative Group. Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts. Gut. 2001;49(3):347-53.
Helicobacter and Cancer Collaborative Group. (2001). Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts. Gut, 49(3), pp. 347-53.
Helicobacter and Cancer Collaborative Group. Gastric Cancer and Helicobacter Pylori: a Combined Analysis of 12 Case Control Studies Nested Within Prospective Cohorts. Gut. 2001;49(3):347-53. PubMed PMID: 11511555.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastric cancer and Helicobacter pylori: a combined analysis of 12 case control studies nested within prospective cohorts. A1 - ,, PY - 2001/8/21/pubmed PY - 2001/9/21/medline PY - 2001/8/21/entrez SP - 347 EP - 53 JF - Gut JO - Gut VL - 49 IS - 3 N2 - BACKGROUND: The magnitude of the association between Helicobacter pylori and incidence of gastric cancer is unclear. H pylori infection and the circulating antibody response can be lost with development of cancer; thus retrospective studies are subject to bias resulting from classification of cases as H pylori negative when they were infected in the past. AIMS: To combine data from all case control studies nested within prospective cohorts to assess more reliably the relative risk of gastric cancer associated with H pylori infection. To investigate variation in relative risk by age, sex, cancer type and subsite, and interval between blood sampling and cancer diagnosis. METHODS: Studies were eligible if blood samples for H pylori serology were collected before diagnosis of gastric cancer in cases. Identified published studies and two unpublished studies were included. Individual subject data were obtained for each. Matched odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for the association between H pylori and gastric cancer. RESULTS: Twelve studies with 1228 gastric cancer cases were considered. The association with H pylori was restricted to non-cardia cancers (OR 3.0; 95% CI 2.3-3.8) and was stronger when blood samples for H pylori serology were collected 10+ years before cancer diagnosis (5.9; 3.4-10.3). H pylori infection was not associated with an altered overall risk of cardia cancer (1.0; 0.7-1.4). CONCLUSIONS: These results suggest that 5.9 is the best estimate of the relative risk of non-cardia cancer associated with H pylori infection and that H pylori does not increase the risk of cardia cancer. They also support the idea that when H pylori status is assessed close to cancer diagnosis, the magnitude of the non-cardia association may be underestimated. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/11511555/full_citation L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&pmid=11511555 DB - PRIME DP - Unbound Medicine ER -