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. © 2008 Springer Science+Business Media B.V.
CITATION STYLE
Epplein, M., Nomura, A. M. Y., Hankin, J. H., Blaser, M. J., Perez-Perez, G., Stemmermann, G. N., … Kolonel, L. N. (2008). Association of Helicobacter pylori infection and diet on the risk of gastric cancer: A case-control study in Hawaii. Cancer Causes and Control, 19(8), 869–877. https://doi.org/10.1007/s10552-008-9149-2
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