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Helicobacter pylori infection, chronic atrophic gastritis and risk of stomach and esophagus cancer: Results from the prospective population‐based ESTHER cohort study
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Titel: |
Helicobacter pylori infection, chronic atrophic gastritis and risk of stomach and esophagus cancer: Results from the prospective population‐based ESTHER cohort study |
In: | International Journal of Cancer, 146, 2020, 10, S. 2773-2783 |
veröffentlicht: |
Wiley
|
Umfang: | 2773-2783 |
ISSN: |
0020-7136 1097-0215 |
DOI: | 10.1002/ijc.32610 |
Zusammenfassung: | <jats:p><jats:italic>Helicobacter pylori</jats:italic> (<jats:italic>H. pylori</jats:italic>) infection is considered as principal cause of gastric cancer. It is further associated with a reduced risk of esophageal adenocarcinomas. In a large prospective population‐based cohort study including 9,949 subjects with average observation time of 13.8 years, we assessed the risk of invasive gastric and esophageal cancer according to <jats:italic>H. pylori</jats:italic> infection and presence of chronic atrophic gastritis (CAG). Incidence rates and hazard ratios (HR) derived by Cox proportional hazards models and adjusted for relevant confounders were derived by seroprevalence of <jats:italic>H. pylori</jats:italic> and cytotoxin‐associated gene A (CagA) antibodies and presence of CAG based on serological markers at baseline, respectively. During follow‐up, 30 cases of noncardia gastric cancer and 33 cases of esophageal cancer were observed. Infection by <jats:italic>H. pylori</jats:italic> without and with expression of CagA was associated with a 5.2‐fold (95% confidence interval 1.00–27.1) and an 18.2‐fold (4.3–77.4) increase of noncardia gastric cancer incidence. A 0.65‐fold decreased risk of esophageal adenocarcinomas (HR 0.35, 0.12–0.97) was observed among <jats:italic>H. pylori</jats:italic>‐infected individuals. In participants infected with CagA expressed <jats:italic>H. pylori</jats:italic>, the presence of mild/moderate and severe CAG was associated with a 6.4‐fold (1.3–31.0) and an 11.8‐fold (3.1–45.4) increase of gastric cancer incidence, respectively. The results of this prospective population‐based cohort study may contribute relevant evidence to the ongoing research of <jats:italic>H. pylori</jats:italic>‐related cancers. The results may furthermore enhance the empirical basis for risk stratification among <jats:italic>H. pylori</jats:italic>‐infected people and for recommendations regarding <jats:italic>H. pylori</jats:italic> screening and treatment among older adults in a Western population.</jats:p> |
Format: | E-Article |
Quelle: | Wiley (CrossRef) |
Sprache: | Englisch |