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Racial Differences in Helicobacter pylori CagA Sero-prevalence in a Consortium of Adult Cohorts in the United States.

About this Publication
Title
Racial Differences in Helicobacter pylori CagA Sero-prevalence in a Consortium of Adult Cohorts in the United States.
Pubmed ID
32856604 (View this publication on the PubMed website)
Digital Object Identifier
Publication
Cancer Epidemiol Biomarkers Prev. 2020 Oct; Volume 29 (Issue 10): Pages 2084-2092
Authors
Varga MG, Butt J, Blot WJ, Le Marchand L, Haiman CA, Chen Y, Wassertheil-Smoller S, Tinker LF, Peek RM, Potter JD, Cover TL, Hyslop T, Zeleniuch-Jacquotte A, Berndt SI, Hildesheim A, Waterboer T, Pawlita M, Epplein M
Affiliations
  • Department of Epidemiology, University of North Carolina Gillings School for Global Public Health and the Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina.
  • Cancer Control and Population Health Sciences Program, Duke Cancer Institute, Durham, North Carolina.
  • Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, Hawaii.
  • University of Southern California and USC Norris Comprehensive Cancer Center, Los Angeles, California.
  • Department of Population Health, New York University School of Medicine, New York, New York.
  • Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York.
  • Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
  • Division of Gastroenterology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Department of Medicine and Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center; Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee.
...show more
  • Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, Rockville, Maryland.
  • Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Cancer Control and Population Health Sciences Program, Duke Cancer Institute, Durham, North Carolina. meira.epplein@duke.edu.
Abstract

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 sero-prevalence 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 = 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 = 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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