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Int J Cancer. 2017 Apr 15;140(8):1727-1735. doi: 10.1002/ijc.30590.

Helicobacter pylori infection, chronic corpus atrophic gastritis and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort: A nested case-control study.

Author information

1
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
2
Department of Public Health and Clinical Nutrition, Umeå University, Umeå, Sweden.
3
Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
4
Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD.
5
Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.
6
Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark.
7
Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
8
Prevention and Implementation Group, Section of Early Detection and Prevention, Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France.
9
Hellenic Health Foundation, Athens, Greece.
10
WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
11
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA.
12
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
13
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
14
Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
15
Translational Research Laboratory, IDIBELL-Catalan Institute of Oncology, Barcelona, Spain.
16
Unit of Nutrition and Cancer. Cancer Epidemiology Research Program. Catalan Institute of Oncology-IDIBELL. L'Hospitalet de Llobregat, Barcelona, Spain.
17
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
18
Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
19
Dipartimento di medicina clinica e chirurgia Federico II, Naples, Italy.
20
Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
21
Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
22
Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
23
Danish Cancer Society Research Center, Copenhagen, Denmark.
24
Andalusian School of Public Health, Instituto De Investigación Biosanitaria Ibs, Granada, Spain.
25
CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
26
Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain.
27
Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain.
28
Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain.
29
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
30
Department of Surgery, Institution of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
31
Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
32
Molecular and Genetic Epidemiology Unit, Human Genetics Foundation, Turin, Italy.
33
Navarra Public Health Institute, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
34
Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Spain.
35
Hormones and Women's Health Team, INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Villejuif, F-94805, France.
36
Université Paris Sud, UMRS 1018, Villejuif, F-94805, France.
37
Institut Gustave Roussy, Villejuif, F-94805, France.
38
Department of Gastroenterology and Pancreatology, Beaujon Hospital, University Paris 7, Clichy, France.
39
Université Paris Sud and Gastroenterology Unit, Hôpitaux Universitaires Paris Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France.
40
Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
41
Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.
42
Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, United Kingdom.
43
Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
44
The Medical Biobank at Umeå University, Umeå, Sweden.

Abstract

The association between H. pylori infection and pancreatic cancer risk remains controversial. We conducted a nested case-control study with 448 pancreatic cancer cases and their individually matched control subjects, based on the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, to determine whether there was an altered pancreatic cancer risk associated with H. pylori infection and chronic corpus atrophic gastritis. Conditional logistic regression models were applied to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs), adjusted for matching factors and other potential confounders. Our results showed that pancreatic cancer risk was neither associated with H. pylori seropositivity (OR = 0.96; 95% CI: 0.70, 1.31) nor CagA seropositivity (OR = 1.07; 95% CI: 0.77, 1.48). We also did not find any excess risk among individuals seropositive for H. pylori but seronegative for CagA, compared with the group seronegative for both antibodies (OR = 0.94; 95% CI: 0.63, 1.38). However, we found that chronic corpus atrophic gastritis was non-significantly associated with an increased pancreatic cancer risk (OR = 1.35; 95% CI: 0.77, 2.37), and although based on small numbers, the excess risk was particularly marked among individuals seronegative for both H. pylori and CagA (OR = 5.66; 95% CI: 1.59, 20.19, p value for interaction < 0.01). Our findings provided evidence supporting the null association between H. pylori infection and pancreatic cancer risk in western European populations. However, the suggested association between chronic corpus atrophic gastritis and pancreatic cancer risk warrants independent verification in future studies, and, if confirmed, further studies on the underlying mechanisms.

KEYWORDS:

EPIC cohort; H. pylori infection; chronic corpus atrophic gastritis; nested case-control study; pancreatic cancer risk

PMID:
28032715
PMCID:
PMC5930360
DOI:
10.1002/ijc.30590
[Indexed for MEDLINE]
Free PMC Article

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