Association of Helicobacter pylori infection and diet on the risk of gastric cancer: a case-control study in Hawaii.
OBJECTIVE
The risk factors most strongly associated with gastric cancer are the gastric bacteria Helicobacter pylori and diet. Utilizing data from a case-control study among residents in Hawaii, we examined the association of diet, presence of H. pylori, and non-cardia gastric cancer risk.


METHODS
Serum taken at diagnosis for cases (n = 212) and at interview for controls (n = 336) was assayed for IgG antibodies to H. pylori group antigens and to a recombinant fragment of the cytotoxin-associated antigen A (CagA) protein, and subjects completed food frequency questionnaires. Risk measures were calculated using logistic regression. The likelihood ratio test was used to assess interactions.


RESULTS
Inverse associations were found between gastric cancer risk and increasing intake of several micronutrients and vegetables among all individuals. For H. pylori/CagA-positive subjects, significant trends were present for total, green, and yellow vegetables, while a significant trend was present only for yellow vegetables among H. pylori/CagA-negative individuals. For intestinal gastric cancer, there was a suggestion that intake of vegetables, especially cruciferous vegetables, had a stronger protective effect for the H. pylori/CagA-positive group.


CONCLUSIONS
Diet may play a greater role in the etiology of non-cardia gastric cancer among individuals with evidence of H. pylori infection than among those without.
Epplein
Meira
M
Epidemiology Program, Cancer Research Center of Hawaii, 1236 Lauhala Street, Honolulu, HI 96813, USA. mepplein@crch.hawaii.edu
Nomura
Abraham M Y
AM
Hankin
Jean H
JH
Blaser
Martin J
MJ
Perez-Perez
Guillermo
G
Stemmermann
Grant N
GN
Wilkens
Lynne R
LR
Kolonel
Laurence N
LN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000097:blood; D001426:Bacterial Proteins / Q000097:blood; D002299:Cardia / Q000382:microbiology; D016022:Case-Control Studies; D004032:Diet; D005006:Ethnicity; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology / Q000472:pathogenicity*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018426:SEER Program; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000382:microbiology
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D007074:Immunoglobulin G; C080866:cagA protein, Helicobacter pylori