title: Risk of gastric cancer in Helicobacter pylori infection in a 15-year follow-up.
abstract: OBJECTIVE
  We investigated the risk of gastric cancer among men with Helicobacter pylori (H. pylori) infection or atrophic gastritis (AG) in a 15-year follow-up.
  
  
  METHODS
  Study population consists of 12,016 men aged 50-65 years at the beginning of the follow-up in 1994-1996. Serum levels of pepsinogen I (SPGI) and antibodies (IgG) to H. pylori (HpAb) were assayed from serums collected in 1994-1996. Incidence of gastric cancer in the study population was assessed in follow-up from 1994 to 2011 by data from the nationwide cancer registry. Based on SPGI and HpAb values, standardized incidence ratios (SIRs) of gastric cancer were calculated in three subgroups, that is, in those with a healthy stomach, those with H. pylori infection but without AG and those with AG. Risk ratios (RR) of gastric cancer were calculated using SIR of subgroups.
  
  
  RESULTS
  During 15 years, seven gastric cancers appeared per 79,928 person years among men with healthy stomachs, 50 cancers per 92,533 person years in men with H. pylori infection but without AG, and 8 per 8658 person years in men with AG. Risk ratio (RR) of stomach cancer in men with H. pylori infection was 5.8 (95%CI: 2.7-15.3) compared to men with healthy stomachs, and 9.1 (95%CI: 2.9-30.0) in men with AG. There were no differences in cancer risk between cardia and distal stomach.
  
  
  CONCLUSIONS
  Risk of gastric cancer is low in men with healthy stomachs. It is significantly increased in those with H. pylori infection and more in those with AG.
authors.affiliation: a Department of Public Health , University of Eastern Finland , Kuopio , Finland ;
authors.forename: Ilkka
authors.initials: I
authors.lastname: Vohlonen
authors.affiliation: b Finnish Cancer Registry , Helsinki , Finland ;
authors.forename: Eero
authors.initials: E
authors.lastname: Pukkala
authors.affiliation: c Department of Epidemiology , Finnish Cancer Registry , Helsinki , Finland ;
authors.forename: Nea
authors.initials: N
authors.lastname: Malila
authors.affiliation: d Department of Clinical Chemistry , University of Helsinki , Helsinki , Finland ;
authors.forename: Matti
authors.initials: M
authors.lastname: Härkönen
authors.affiliation: c Department of Epidemiology , Finnish Cancer Registry , Helsinki , Finland ;
authors.forename: Matti
authors.initials: M
authors.lastname: Hakama
authors.affiliation: e Department of Biostatistics , Finnish Consulting Group , Helsinki , Finland ;
authors.forename: Veli
authors.initials: V
authors.lastname: Koistinen
authors.affiliation: f Department of Pathology , Patolab Oy , Espoo , Finland.
authors.forename: Pentti
authors.initials: P
authors.lastname: Sipponen
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D005387:Finland; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000097:blood / Q000150:complications* / Q000382:microbiology; D016481:Helicobacter Infections / Q000097:blood / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020116:Pepsinogen A / Q000097:blood; D012042:Registries; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000907:Antibodies, Bacterial; D020116:Pepsinogen A
keywords: Atrophic gastritis; Helicobacter pylori; gastric cancer