Atrophic gastritis, Helicobacter pylori, and colorectal cancer risk: a case-control study.
BACKGROUND
Helicobacter pylori is a major risk factor for atrophic gastritis and gastric cancer. Various extragastric manifestations of H. pylori infection have also recently been suggested. However, the correlation between H. pylori and colorectal cancer (CRC) is controversial. The aim of this study was to examine the correlation between H. pylori, serum gastrin level, and atrophic gastritis with CRC.


METHODS
Subjects were patients with CRC; controls were participants of a health check-up program that was conducted between October 1998 and March 2002 at four hospitals in Nagano Prefecture. For 121 newly diagnosed CRC cases, two controls matched by age (within 3 years), gender, and residence were randomly selected from the program participants. We conducted questionnaires and obtained blood samples from the cases and their controls. Consequently, the CRC cancer pairs consisted of 113 cases and 226 controls.


RESULTS
Neither H. pylori infection nor gastrin level nor atrophic gastritis showed any association with a risk for CRC. However, serologically determined atrophic gastritis demonstrated significant elevation in odds ratios (ORs) for rectal cancer (OR = 3.15, 95% confidence interval; 1.19-8.35).


CONCLUSIONS
Gastric conditions such as chronic H. pylori infection and atrophic gastritis are unlikely to increase the risk for CRC, although atrophic gastritis may increase the risk of rectal cancer.
Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Ai
A
Machida-Montani
Shizuka
S
Sasazuki
Manami
M
Inoue
Syusuke
S
Natsukawa
Kozo
K
Shaura
Yoichi
Y
Koizumi
Yoshio
Y
Kasuga
Tomoyuki
T
Hanaoka
Shoichiro
S
Tsugane
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D016001:Confidence Intervals; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires
D005755:Gastrins