AUTHOR=Fernández de Larrea-Baz Nerea , Michel Angelika , Romero Beatriz , Pérez-Gómez Beatriz , Moreno Victor , Martín Vicente , Dierssen-Sotos Trinidad , Jiménez-Moleón José J. , Castilla Jesús , Tardón Adonina , Ruiz Irune , Peiró Rosana , Tejada Antonio , Chirlaque María D. , Butt Julia A. , Olmedo-Requena Rocío , Gómez-Acebo Inés , Linares Pedro , Boldo Elena , Castells Antoni , Pawlita Michael , Castaño-Vinyals Gemma , Kogevinas Manolis , de Sanjosé Silvia , Pollán Marina , del Campo Rosa , Waterboer Tim , Aragonés Nuria 

TITLE=Helicobacter pylori Antibody Reactivities and Colorectal Cancer Risk in a Case-control Study in Spain

JOURNAL=Frontiers in Microbiology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2017.00888

DOI=10.3389/fmicb.2017.00888

ISSN=1664-302X

ABSTRACT=<p><bold>Background:</bold> Several studies have suggested that <italic>Helicobacter pylori</italic> (<italic>H. pylori</italic>) infection is a risk factor for colorectal cancer (CRC), while others have not confirmed this hypothesis. This work aimed to assess the relation of CRC with <italic>H. pylori</italic> seropositivity and with seropositivity to 16 <italic>H. pylori</italic> proteins, in the MultiCase-Control study, MCC-Spain.</p><p><bold>Methods:</bold> MCC-Spain is a multicase-control study carried out in Spain from 2008 to 2013. In total, 2,140 histologically-confirmed incident CRC cases and 4,098 population-based controls were recruited. Controls were frequency-matched by sex, age, and province. Epidemiological data were collected through a questionnaire fulfilled by face-to-face interviews and a self-administered food-frequency questionnaire. Seroreactivities against 16 <italic>H. pylori</italic> proteins were determined in 1,488 cases and 2,495 controls using <italic>H. pylori</italic> multiplex serology. <italic>H. pylori</italic> seropositivity was defined as positivity to ≥4 proteins. Multivariable logistic regression mixed models were used to estimate odds ratios (OR) and 95% confidence intervals (CI).</p><p><bold>Results:</bold><italic>H. pylori</italic> seropositivity was not associated with increased CRC risk (OR = 0.91; 95% CI: 0.71–1.16). Among <italic>H. pylori</italic> seropositive subjects, seropositivity to Cagδ showed a lower CRC risk, and risk decreased with increasing number of proteins seropositive. Seropositivity to the most recognized virulence factors, CagA and VacA, was not associated with a higher CRC risk. No statistically significant heterogeneity was identified among tumor sites, although inverse relations were stronger for left colon cancer. An interaction with age and sex was found: <italic>H. pylori</italic> seropositivity was associated with a lower CRC risk in men younger than 65 and with a higher risk in older women.</p><p><bold>Conclusions:</bold> Our results suggest that neither <italic>H. pylori</italic> seropositivity, nor seropositivity to the virulence factor CagA are associated with a higher CRC risk. A possible effect modification by age and sex was identified.</p>