Antibody responses to Helicobacter pylori and risk of developing colorectal cancer in a European cohort

Julia Butt, Mazda Jenab, Michael Pawlita, Anne Tjonneland, Cecilie Kyrø, Marie-Christine Boutron-Ruault, Franck Carbonnel, Catherine Dong, Rudolf Kaaks, Tilman Kühn, Heiner Boeing, Matthias B Schulze, Antonia Trichopoulou, Anna Karakatsani, Carlo La Vecchia, Domenico Palli, Claudia Agnoli, Rosario Tumino, Carlotta Sacerdote, Salvatore PanicoBas Bueno-de-Mesquita, Roel Vermeulen, Inger T Gram, Elisabete Weiderpass, Kristin Benjaminsen Borch, J Ramón Quirós, Antonio Agudo, Miguel Rodríguez-Barranco, Carmen Santiuste, Eva Ardanaz, Bethany Van Guelpen, Sophia Harlid, Liher Imaz, Aurora Perez-Cornago, Marc J Gunter, Semi Zouiouich, Jin Young Park, Elio Riboli, Amanda J Cross, Alicia K Heath, Tim Waterboer, David J Hughes

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3 Citations (Scopus)


BACKGROUND: While Helicobacter pylori (H. pylori) is the major cause of gastric cancer, it has also been suggested to be involved in colorectal cancer (CRC) development. However, prospective studies addressing H. pylori and CRC are sparse and inconclusive. We assessed the association of antibody responses to H. pylori proteins with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

METHODS: We applied H. pylori multiplex serology to measure antibody responses to 13 H. pylori proteins in pre-diagnostic serum samples from 485 CRC cases and 485 matched controls nested within the EPIC study. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable conditional logistic regression to estimate the association of H. pylori overall and protein-specific sero-positivity with odds of developing CRC.

RESULTS: Fifty-one percent of CRC cases were H. pylori sero-positive compared to 44% of controls resulting in an OR of 1.36 (95% CI: 1.00-1.85). Among the 13 individual H. pylori proteins, the association was driven mostly by sero-positivity to Helicobacter cysteine-rich protein C (HcpC) (OR: 1.66, 95% CI: 1.19-2.30) and Vacuolating cytotoxin A (VacA) (OR: 1.34, 95% CI: 0.99-1.82), the latter being non-statistically significant only in the fully adjusted model.

CONCLUSION: In this prospective multi-center European study, antibody responses to H. pylori proteins, specifically HcpC and VacA, were associated with an increased risk of developing CRC.

IMPACT: Biological mechanisms for a potential causal role of H. pylori in colorectal carcinogenesis need to be elucidated, and subsequently whether H. pylori eradication may decrease CRC incidence.

Original languageEnglish
JournalCancer Epidemiology Biomarkers & Prevention
Early online date24 Apr 2020
Publication statusEarly online date - 24 Apr 2020

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Copyright ©2020, American Association for Cancer Research.


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