Environmental factors in Helicobacter pylori-related gastric precancerous lesions in Venezuela.
Although Helicobacter pylori (HP) infection has been acknowledged to play an etiological role in gastric carcinogenesis, its relatively weak association particularly in developing countries suggests critical roles of cofactors. Among a population with an extremely high prevalence of HP infection ( approximately 95%) in Venezuela, we examined the relationship of household characteristics, smoking, alcohol drinking, dietary consumption, and plasma nutrient levels with the prevalence of three different stages of gastric precancerous lesions, chronic atrophic gastritis (AG; n = 337), intestinal metaplasia (IM; n = 551), and dysplasia (n = 157), in comparison with those without any of these lesions (n = 1154). Length of refrigerator use was marginally inversely associated with the prevalence of the precursor lesions studied. The association was most pronounced for AG followed by dysplasia. On the other hand, smoking status was a significant predictor for IM and dysplasia. Those smoking >/=>10 cigarettes/day had 1.8-fold risk of IM and 3.6-fold risk of dysplasia compared with never smokers. There were no associations with alcohol consumption. When six food groups known to be associated with stomach cancer risk in Venezuela were tested, the prevalence of these lesions progressively increased with increasing starchy vegetable consumption and decreasing fresh fruit/fruit juice consumption. The association with fruits was more evident for dysplasia and AG and that with starchy vegetables for IM and AG. However, there were no inverse associations with plasma antioxidant vitamins. These findings offer important public health implications in preventing progression of HP-associated gastric precancerous lesions in high-risk populations.
Karmanos Cancer Institute/Department of Pathology, Wayne State University, Detroit MI, USA. katoi@med.wayne.edu
Ikuko
I
Kato
Jorge
J
Vivas
Martyn
M
Plummer
Gladys
G
Lopez
Simon
S
Peraza
Dennis
D
Castro
Victor
V
Sanchez
Elsa
E
Cano
Olga
O
Andrade
Rita
R
Garcia
Silvia
S
Franceschi
Walter
W
Oliver
Nubia
N
Muñoz
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D016022:Case-Control Studies; D003906:Developing Countries; D004032:Diet; D004777:Environment; D005260:Female; D005638:Fruit; D005757:Gastritis, Atrophic / Q000150:complications / Q000208:ethnology* / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009752:Nutritional Status; D011230:Precancerous Conditions / Q000209:etiology / Q000382:microbiology*; D012307:Risk Factors; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000208:ethnology* / Q000209:etiology / Q000382:microbiology*; D014675:Vegetables; D014687:Venezuela / Q000453:epidemiology