TY - JOUR
T1 - Racial differences in Helicobacter pylori CagA sero-prevalence in a consortium of adult cohorts in the United States
AU - Varga, Matthew G.
AU - Butt, Julia
AU - Blot, William J.
AU - Le Marchand, Loic
AU - Haiman, Christopher A.
AU - Chen, Yu
AU - Wassertheil-Smoller, Sylvia
AU - Tinker, Lesley F.
AU - Peek, Richard M.
AU - Potter, John D.
AU - Cover, Timothy L.
AU - Hyslop, Terry
AU - Zeleniuch-Jacquotte, Anne
AU - Berndt, Sonja I.
AU - Hildesheim, Allan
AU - Waterboer, Tim
AU - Pawlita, Michael
AU - Epplein, Meira
N1 - Funding Information:
This work was supported by the NIH grants (R01 CA190428 to M. Epplein; U01 CA202979 to W.J. Blot; UM1 CA182934 to A. Zeleniuch-Jacquotte; U01 CA164973 to L. Le Marchand; R01 DK058587 and R01 CA077955 to R.M. Peek Jr; R01 AI039657, R01 AI118932, and P01 CA116087 to T.L. Cover; and T32 CA057726 for fellowship support to M.G. Varga), contracts to the WHI from the U.S. Department of Health and Human Services (HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C), and the Department of Veterans Affairs (1I01BX004447 to T.L. Cover). The development of H. pylori multiplex serology was funded, in part, by the Joint Initiative for Innovation and Research of the German Helmholtz Association.
Publisher Copyright:
© 2020 American Association for Cancer Research.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Background: Prevalence of Helicobacter pylori (H. pylori) infection, the main risk factor for gastric cancer, has been decreasing in the United States; however, there remains a substantial racial disparity. Moreover, the time-trends for prevalence of CagA-positive H. pylori infection, the most virulent form, are unknown in the U.S. population. We sought to assess prevalence of CagA-positive H. pylori infection over time by race in the United States. Methods: We utilized multiplex serology to quantify antibody responses to H. pylori antigens in 4,476 participants across five cohorts that sampled adults from 1985 to 2009. Using log-binomial regression models, we calculated prevalence ratios and 95% confidence intervals for the association between H. pylori–CagA seroprevalence and birth year by race. Results: African Americans were three times more likely to be H. pylori–CagA sero-positive than Whites. After adjustment, H. pylori–CagA sero-prevalence was lower with increasing birth year among Whites (Ptrend ¼ 0.001), but remained stable for African Americans. When stratified by sex and education separately, the decline in H. pylori–CagA sero-positivity among Whites remained only for females (Ptrend < 0.001) and was independent of educational attainment. Among African Americans, there was no difference by sex; furthermore, sero-prevalence increased with increasing birth year among those with a high school education or less (P ¼ 0.006). Conclusions: Among individuals in the United States born from the 1920s to 1960s, H. pylori–CagA sero-prevalence has declined among Whites, but not among African Americans. Impact: Our findings suggest a widening racial disparity in the prevalence of the most virulent form of H. pylori, the main cause of gastric cancer.
AB - Background: Prevalence of Helicobacter pylori (H. pylori) infection, the main risk factor for gastric cancer, has been decreasing in the United States; however, there remains a substantial racial disparity. Moreover, the time-trends for prevalence of CagA-positive H. pylori infection, the most virulent form, are unknown in the U.S. population. We sought to assess prevalence of CagA-positive H. pylori infection over time by race in the United States. Methods: We utilized multiplex serology to quantify antibody responses to H. pylori antigens in 4,476 participants across five cohorts that sampled adults from 1985 to 2009. Using log-binomial regression models, we calculated prevalence ratios and 95% confidence intervals for the association between H. pylori–CagA seroprevalence and birth year by race. Results: African Americans were three times more likely to be H. pylori–CagA sero-positive than Whites. After adjustment, H. pylori–CagA sero-prevalence was lower with increasing birth year among Whites (Ptrend ¼ 0.001), but remained stable for African Americans. When stratified by sex and education separately, the decline in H. pylori–CagA sero-positivity among Whites remained only for females (Ptrend < 0.001) and was independent of educational attainment. Among African Americans, there was no difference by sex; furthermore, sero-prevalence increased with increasing birth year among those with a high school education or less (P ¼ 0.006). Conclusions: Among individuals in the United States born from the 1920s to 1960s, H. pylori–CagA sero-prevalence has declined among Whites, but not among African Americans. Impact: Our findings suggest a widening racial disparity in the prevalence of the most virulent form of H. pylori, the main cause of gastric cancer.
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U2 - 10.1158/1055-9965.EPI-20-0525
DO - 10.1158/1055-9965.EPI-20-0525
M3 - Article
C2 - 32856604
AN - SCOPUS:85102286083
VL - 29
SP - 2084
EP - 2092
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
SN - 1055-9965
IS - 10
ER -