Helicobacter pylori infection and the risk of gastric carcinoma

Article Abstract:

Gastric carcinoma (stomach cancer) is the second most common cancer worldwide: although its incidence is declining in the US and western Europe, it is still very common in Latin America and Asia. Infection with Helicobacter pylori, formerly called Campylobacter pylori, is associated with gastric carcinoma. Studies have indicated that H. pylori is particularly related with the intestinal type of adenocarcinoma; the other is the diffuse type. The availability of a blood test for H. pylori makes it possible to diagnose the infection noninvasively. This test was used in a case-control study at a large health maintenance organization to determine the risks for gastric carcinoma. Blood samples collected in the 1960s from 186 patients who developed gastric carcinoma (cases) were analyzed for H. pylori antibodies. Blood samples from the same number of patients without the disease (controls) were also analyzed. Controls were matched with regard to sex, race, age at serum donation, date of donation, and site where the donation occurred. Analysis of tissue biopsy specimens from most of the cases was also carried out. Results showed that infection with H. pylori was a risk factor for gastric adenocarcinoma, both the intestinal and diffuse types. Eighty-four percent of 109 patients with this disease were infected with H. pylori, compared with 61 percent of the controls, yielding a threefold-elevated risk for those who were infected. H. pylori infection was a particularly important risk factor for gastric adenocarcinoma in women (18-fold elevated risk compared with controls) and blacks (9-fold elevation). Peptic ulcer disease was negatively associated with stomach cancer. Smoking and blood group did not appear to be factors in developing the disease. however, a history of stomach surgery was a risk factor for stomach cancer. Although it is possible that vulnerability to H. pylori and cancer are caused by a third factor, this is unlikely. The physiological reasons for this are enumerated. H. pylori infection can not be considered the sole explanation for stomach cancer, since it is very common. A reasonable estimate of its role in gastric carcinoma is that it causes 60 percent of the disease worldwide. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Risk factors, Helicobacter infections, Stomach cancer, Epidemiological research, Cross sectional studies

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Serum cholesterol and mortality among Japanese-American men: the Honolulu (Hawaii) Heart Program

Article Abstract:

Results are presented from a long-term study of blood cholesterol levels and coronary heart disease (CHD, disease of the arteries that deliver blood to the heart muscle) in Japanese-American males living in Hawaii. This population is of interest because the death rate from CHD among US white men has been shown to be four times the rate among men in Japan, while Japanese-Americans have a rate that lies in between. Blood cholesterol levels among US and Japanese men in the 1960s averaged, respectively, 232 and 176 milligrams per deciliter; among Japanese living in Hawaii, cholesterol levels averaged 218 milligrams per deciliter. The current study, part of the Honolulu Heart Program, is a follow-up of this group of Japanese-Americans who were studied from the 1960s through 1986. Results for the 7,961 men tested showed that mortality due to cancer was greater than mortality due to CHD, particularly after age 65. CHD increased in prevalence as the levels of cholesterol increased, as did the rate of nonhemorrhagic stroke (decrease in blood flow to a region of the brain due to blockage of a blood vessel). The incidence of most types of cancer was inversely related to cholesterol level (low cholesterol levels were associated with greater cancer incidence). The risk of death due to CHD was directly related to the baseline cholesterol level at all times tested. The inverse relationship between cancer and cholesterol level held at all times, but was significant only during the first six years after the study started. The results show, as have other studies, that the male mortality curve is U-shaped with respect to cholesterol levels: men with very low, or very high, cholesterol levels have higher death rates. A discussion is presented of the vulnerability to cancer of US citizens of Japanese ancestry and of the possible, but unproven, relationship between undiagnosed cancer (with its nutritional demands) and low cholesterol levels. Reducing cholesterol levels in the general population is a goal that should be pursued cautiously. (Consumer Summary produced by Reliance Medical Information, Inc.)

Coronary heart disease, Diseases, Hypercholesterolemia, Japanese Americans

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