Gastric cancer: smoking and Helicobacter led to a higher risk

https://cancerpreventionresearch.aacrjournals.org/content/12/10/667

Because of the lack of understanding of the complex and serial events which precede a gastric tumour, we under-estimate the carcinogenic potential of smoking and we let people playing Russian roulette

"Smoking is an established risk factor for gastric cancer development. In this study, we aimed to assess prospectively the association of smoking with gastric cancer risk in 1,446 non-cardia gastric cancer cases and 1,796 controls from China, Japan, and Korea with consideration of Helicobacter pylori infection as a potential effect modifier. Applying logistic regression models stratified by study and adjusted for age and sex we found that current, but not former, smoking was significantly associated with gastric cancer risk [OR = 1.33; 95% confidence interval (CI), 1.07–1.65]. However, the association was significant only in H. pylori sero-positive individuals determined by 3 different sero-markers: overall sero-positivity, sero-positivity to the onco-protein CagA, and sero-positivity to the gastric cancer associated sero-marker HP0305 and HP1564. Specifically, a significant interaction was found when stratifying by HP0305/HP1564 (Pinteraction = 0.01) with a 46% increased risk of gastric cancer among HP0305/HP1564 sero-positive current smokers (95% CI, 1.10–1.93) as opposed to no increased gastric cancer risk among HP0305/HP1564 sero-negative current smokers (OR = 0.93; 95% CI, 0.65–1.33). We confirmed that current smoking is associated with an increased gastric cancer risk, however, only among individuals that are simultaneously sero-positive for the leading causal factor for gastric cancer, H. pylori."

Gastric cancer and especially its deadly form named signet-ring cell gastric carcinoma is poorly understood despite its association with HP. 

In conclusion, our results from this large prospective
consortium of East Asian studies confirmed that current
smoking increases the risk of developing non-cardia
gastric cancer, however, only among study participants simultaneously harboring antibodies to H. pylori, CagA-positive H. pylori, or the gastric cancer risk marker H. pylori HP0305/HP1564. Our findings suggest that in areas of
high H. pylori prevalence like East Asia, smoking status is a
further risk marker of gastric cancer incidence,and potentially smoking cessation could be an effective strategy to reduce gastric cancer risk.

Gastric cancer