Aim: To evaluate the relationship between Helicobacter pylori infection and gastric cancer in Japan.
Methods: This was a multicentre study conducted in various regions in Japan. A total of 6578 individuals as controls and 2503 with histologically confirmed gastric cancer were enrolled. H. pylori status was determined by enzyme-linked immunosorbent assay (ELISA) for anti-H. pylori immunoglobulin G (IgG).
Results: The prevalence of H. pylori infection in gastric cancer patients was markedly high in all age groups. In contrast, the rate increased with age among control subjects. The overall prevalence of H. pylori infection in control subjects was 50.2% (3300/6578) vs. 82.8% in gastric cancer patients (2072/2503) (OR = 2.47; 95% CI: 2.19-2.79). The prevalence of H. pylori in early gastric cancer was significantly higher than that in advanced gastric cancer (86.5% vs. 75.7%; OR = 2.06; 95% CI: 1.66-2.55). There were no significant differences in the prevalence of H. pylori between the intestinal and diffuse types of gastric cancer or among gastric cancer in antrum, body and cardia.
Conclusion: H. pylori infection is strongly associated with the development of gastric cancer. The difference in odds ratios among younger and older persons with gastric cancer likely reflects the decrease in prevalence of H. pylori in the population, and is more reflective of the actual risks associated with the infection.