Lessons from the epidemiology of Helicobacter pylori and cancer

摘要: In 1994 the International Agency for Research on Cancer (IARC) declared Helicobacter pylori to be a type I carcinogen, definite cause of cancer in humans1. The strongest support this assertion came from epidemiological studies solidly linking infection with later development malignancy. Bolstering these findings are series laboratory demonstrating credible mechanisms H. pylori-induced carcinogenesis, including: enhanced cell proliferation, induction reactive oxygen species and intraepithelial formation mutagenic oxidative DNA adducts2–4. Similarities between gastric inflammation other inflammatory precursors at sites (e.g. schistosomiasis hepatitis B infection) reinforce likelihood an pylori-gastric link. Yet IARC statement remains controversial, largely because have not been completely consistent across all populations statistical associations often viewed some scepticism. years before since statement, papers published refuting role adenocarcinoma5,6. While negative (particularly those presented as abstracts) dubious quality, others well conducted contain few obvious sources bias. chapter, will address question: if is so critical why do show association?