Association of Helicobacter pylori infection with reduced risk for esophageal cancer is independent of environmental and genetic modifiers.

Abstract:

BACKGROUND & AIMS:Infection with Helicobacter pylori is associated with reduced risk of esophageal adenocarcinoma (EAC), but it is not clear whether this reduction is modified by genotype, other host characteristics, or environmental factors. Furthermore, little is known about the association between H pylori and adenocarcinomas of the esophagogastric junction (EGJAC) or squamous cell carcinomas (ESCC). We sought to measure the association between H pylori infection and esophageal cancer and identify potential modifiers. METHODS:In an Australian, population-based, case-control study, we compared the prevalence of H pylori seropositivity and single nucleotide polymorphisms in interleukin (IL)-1B (-31, -511) and tumor necrosis factor (TNF)-alpha (-308, -238) among 260 EAC, 298 EGJAC, and 208 ESCC patients and 1346 controls. To estimate relative risks, we calculated odds ratios (OR) and 95% confidence intervals (CI) using multivariable logistic regression in the entire sample and within strata of phenotypic and genotypic risk factors. RESULTS:H pylori infection was associated with significantly reduced risks of EAC (OR, 0.45; 95% CI: 0.30-0.67) and EGJAC (OR, 0.41; 95% CI: 0.27-0.60) but not ESCC (OR, 1.04; 95% CI: 0.71-1.50). For each cancer subtype, risks were of similar magnitude across strata of reflux frequency and smoking status. We found no evidence that polymorphisms in IL-1B or TNF-alpha modified the association between H pylori and EAC or EGJAC. CONCLUSIONS:H pylori infection is inversely associated with risks of EAC and EGJAC (but not ESCC); the reduction in risk is similar across subgroups of potential modifiers.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Whiteman DC,Parmar P,Fahey P,Moore SP,Stark M,Zhao ZZ,Montgomery GW,Green AC,Hayward NK,Webb PM,Australian Cancer Study.

doi

10.1053/j.gastro.2010.04.009

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

73-83; quiz e11-2

issue

1

eissn

0016-5085

issn

1528-0012

pii

S0016-5085(10)00556-1

journal_volume

139

pub_type

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