Identifying the Profile of Helicobacter Pylori-Negative Gastric Cancers: A Case-Only Analysis Within the Stomach Cancer Pooling (Stop) Project Publisher Pubmed



Morais S^{1, 2, 3} ; Peleteiro B^{1, 2, 3} ; Araujo N^{1, 2, 3} ; Malekzadeh R⁴ ; Ye W⁵ ; Plymoth A⁵ ; Tsugane S⁶ ; Hidaka A⁶ ; Hamada GS⁷ ; Lopezcarrillo L⁸ ; Zaridze D⁹ ; Maximovich D⁹ ; Aragones N^{10, 11} ; Castanovinyals G^{11, 12, 13, 14} Show All Authors
Source: Cancer Epidemiology Biomarkers and Prevention Published:2022

Abstract

Background: The prevalence of Helicobacter pylori-negative gastric cancer (HpNGC) can be as low as 1%, when infection is assessed using more sensitive tests or considering the presence of gastric atrophy. HpNGC may share a high-risk profile contributing to the occurrence of cancer in the absence of infection.Weestimated the proportion of HpNGC, using different criteria to define infection status, and compared HpNGC and positive cases regarding gastric cancer risk factors. Methods: Cases from 12 studies from the Stomach cancer Pooling (StoP) Project providing data on H. pylori infection status determined by serologic test were included. HpNGC was reclassified as positive (eight studies) when cases presented CagA markers (four studies), gastric atrophy (six studies), or advanced stage at diagnosis (three studies), and were compared with positive cases. A two-stage approach (random-effects models) was used to pool study-specific prevalence and adjusted odds ratios (OR). Results: Among non-cardia cases, the pooled prevalence of HpNGC was 22.4% (n = 166/853) and decreased to 7.0% (n = 55) when considering CagA status; estimates for all criteria were 21.8% (n = 276/1,325) and 6.6% (n = 97), respectively. HpNGC had a family history of gastric cancer more often [OR = 2.18; 95% confidence interval (CI), 1.03-4.61] and were current smokers (OR = 2.16; 95% CI, 0.52-9.02). Conclusion: This study found a low prevalence of HpNGC, who are more likely to have a family history of gastric cancer in first-degree relatives. © 2022 American Association for Cancer Research Inc.. All rights reserved.