Association between Helicobacter pylori and pancreatic cancer risk: a meta-analysis
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Gastric colonization with Helicobacter pylori (H. pylori) has been implicated in the pathogenesis of pancreatic cancer, but results of epidemiological studies have been inconclusive. We analyzed data from the Queensland Pancreatic Cancer Study, an Australian population-based case–control study, and incorporated our findings into an updated meta-analysis.
Blood samples were obtained from 580 patients and 626 controls, and enzyme-linked immunosorbent assay kits were used to determine seropositivity to H. pylori and its virulence protein, cytotoxin-associated gene A (CagA). Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using logistic regression. Results were incorporated into a meta-analysis along with results of studies identified through systematic literature review. Adjusted ORs and 95 % CIs were calculated using the DerSimonian and Laird random-effects model.
No overall association was observed between H. pylori seropositivity and risk of pancreatic cancer (OR 1.00; 95 % CI 0.74–1.35). Nonsignificantly decreased pancreatic cancer risk was observed with CagA seropositivity (OR 0.74; 95 % CI 0.48–1.15) and increased risk with CagA-negative H. pylori seropositivity (OR 1.23; 95 % CI 0.83–1.82). Ten studies were included in the meta-analysis. There was no significant overall association between H. pylori seropositivity and pancreatic cancer risk (OR 1.13; 95 % CI 0.86–1.50), but evidence of CagA strain-specific associations (OR 0.78; 95 % CI 0.67–0.91 and OR 1.30; 95 % CI 1.02–1.65 for CagA-positive and CagA-negative strains, respectively).
Our results provide further evidence for the existence of strain-specific associations between H. pylori and pancreatic cancer.
KeywordsPancreatic neoplasms Helicobacter pylori Epidemiology Risk factors
We would like to acknowledge the support of the participants in this study. This study would not have been possible without the invaluable contribution of the research nurses, Fran Millar and Lisa Ferguson. The Queensland Pancreatic Cancer Study was funded by a National Health and Medical Research Council Australia (NHMRC) Project Grant. P Webb and L Fritschi are funded by NHMRC Senior Research Fellowships and N Pandeya by an NHMRC postdoctoral fellowship. D Whiteman is funded by an Australian Research Council Future fellowship.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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