Advertisement

Gastric cancer epidemiology and risk factors

  • Jon R. Kelley
    Affiliations
    Department of Veterans' Affairs, Commonwealth of Australia, G.P.O. Box 651, Brisbane Queensland 4001, Australia
    Search for articles by this author
  • John M. Duggan
    Correspondence
    Corresponding author. Princeton Medical Centre, 60 Lindsay Street, Hamilton, NSW, 2303, Australia. Tel.: 61 2 49 61 2090; fax: 61 2 49 62 3443.
    Affiliations
    Repatriation Medical Authority, Commonwealth of Australia, G.P.O. Box 1014, Brisbane Queensland, Australia

    Discipline of Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health Science, University of Newcastle, Pacific Street, Newcastle, NSW 2300, Australia
    Search for articles by this author

      Abstract

      We performed a detailed analysis of the epidemiology of gastric carcinoma, based upon a review of the literature in English. The analysis reveals many puzzling features. There has been a steady fall in the incidence of gastric carcinoma in most societies studied, but a more recent steady rise in the incidence of adenocarcinoma of the cardia and lower esophagus, largely confined to White males. Although the evidence for a major role for Helicobacter pylori (H. pylori) in the etiology of gastric corpus cancer is compelling; in Western society, it probably accounts for fewer than half the cases. The relative roles of dietary constituents such as salt and nitrites and the phenotyping of H. pylori in causation and the beneficial effects of a high fruit and vegetable diet and an affluent lifestyle, for all of which there is some evidence, are yet to be quantified.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Clinical Epidemiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Howson C.P.
        • Hiyama T.
        • Wynder E.L.
        The decline of gastric cancer.
        Epidemiol Rev. 1986; 8: 1-27
        • Parkin D.M.
        • Pisani P.
        • Ferlay J.
        Estimates of the worldwide incidence of eighteen major cancers in 1985.
        Int J Cancer. 1993; 54: 594-606
        • Pisani P.
        • Parkin D.M.
        • Ferlay J.
        Estimates of worldwide mortality from eighteen major cancers in 1985. Implications for prevention, and projections of future burden.
        Int J Cancer. 1993; 54: 891-903
        • Jass J.R.
        Tumours of the stomach.
        in: McGee J. O'D Isaacson P.G. Wright N.A. Oxford textbook of pathology. Oxford University Press;, Oxford1992: 1165-1173
        • Lauren P.
        The two histological main types of gastric carcinoma.
        Acta Pathol Microbiol Scand. 1965; 64: 31-49
        • Parkin D.M.
        • Whelan S.L.
        • Ferlay J.
        • et al.
        Cancer incidence in five continents, vol VII. International Agency for Research on Cancer;, Lyon1997 (p. 822–3.)
        • Parkin D.M.
        • Whelan S.L.
        • Ferlay J.
        • et al.
        Cancer incidence in five continents, vol VII. International Agency for Research on Cancer;, Lyon1997 (p. 922–4.)
        • Munoz N.
        • Correa P.
        • Cuello C.
        • et al.
        Histological types of gastric carcinoma in high and low risk areas.
        Int J Cancer. 1968; 3: 809-818
        • Sipponen P.
        • Javri O.
        • Kekki M.
        • et al.
        Decreased incidences of intestinal and diffuse types of gastric carcinoma in Finland during a 20-year period.
        Scand J Gastroenterol. 1987; 22: 865-871
        • Haenszel W.
        • Kurihara M.
        Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States.
        J Natl Cancer Inst. 1968; 40: 43-68
      1. IARC Unit of Descriptive Epidemiology. WHO cancer mortality databank. Cancer Mondial. www-dep.iarc.fr/dataava/globocan/who.htm; 2001.

        • Powell J.
        • McConkey C.C.
        The rising trend in oesophageal adenocarcinoma and gastric cardia.
        Eur J Cancer Prev. 1992; 1: 265-269
        • Zheng T.
        • Mayne S.T.
        • Holford T.R.
        • et al.
        The time trend and age-period-cohort effects in incidence of adenocarcinoma of the stomach in Connecticut from 1955–1989.
        Cancer. 1993; 72: 330-340
        • Blot W.J.
        • Devesa S.S.
        • KIneller R.W.
        • et al.
        Rising incidence of adenocarcinoma of the esophagus and gastric cardia.
        JAMA. 1991; 265: 1287-1289
        • Wang H.L.
        • Antonioli D.A.
        • Goldman H.
        Comparative features of esophageal and gastric adenocarcinomas. Recent changes in type and frequency.
        Hum Pathol. 1986; 17: 482-487
        • Pera M.
        • Cameron A.J.
        • Trastek V.F.
        • Carpenter H.A.
        • Zinmeister A.R.
        Increasing incidence of adenocarcinoma of the esophagus and esophagogastric junction.
        Gastroenterology. 1993; 104: 510-513
        • Hannsson L.E.
        • Sparun P.
        • Nyrun O.
        Increasing incidence of both major histological types of esophageal carcinomas among men in Sweden.
        Int J Cancer. 1993; 54: 402-407
        • Lord R.V.N.
        • Law M.G.
        • Ward R.L.
        • Giles G.G.
        • Thomas R.J.S.
        • Thursfield V.
        Rising Incidence of oesophageal adenocarcinoma in men in Australia.
        J Gastroenterol Hepatol. 1998; 13: 356-362
        • Levi F.
        • La Vecchia C.
        Adenocarcinoma of the esophagus in Switzerland.
        JAMA. 1991; 265 ([letter]): 2960
        • Lagergren J.
        • Bergstrom R.
        • Lindgren A.
        • Nyren O.
        Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma.
        N Engl J Med. 1999; 340: 825-831
        • Lagergren J.
        • Bergstrom R.
        • Nyren O.
        Association between body mass and adenocarcinoma of the oesophagus and gastric cardia.
        Ann Intern Med. 1999; 130: 883-890
        • Chow W.H.
        • Blot W.J.
        • Vaughan T.L.
        • et al.
        Body mass index and the risk of adenocarcinoma of the esophagus and gastric cardia.
        J Natl Cancer Inst. 1998; 90: 150-155
        • Terry P.
        • Lagergren J.
        • Ye W.
        • Wolk F.
        • Nyren O.
        Inverse association between intake of cereal fibre and risk of gastric cardia cancer.
        Gastroenterology. 2001; 120: 387-391
      2. Mowat C, Carswell A, McColl KEI. Omeprazole lowers gastric juice ascorbic acid and elevates gastric juice nitrite concentrations. Gut 1998(Suppl)42:A67.

        • Marshall B.J.
        Unidentified curved bacilli on gastric epithelium in active chronic gastritis.
        Lancet. 1983; i: 1273-1277
        • International Agency for Research on Cancer
        Schistosomes, liver flukes and Helicobacter pylori. IARC monographs on the evaluation of carcinogenic risks to humans, vol. 61. International Agency for Research on Cancer;, Lyon1994
        • The Eurogast Study Group
        An international association between Helicobacter pylori infection and gastric cancer.
        Lancet. 1993; 341: 1359-1362
        • Banatvala N.
        • Mayo K.
        • Megraud F.
        • et al.
        The cohort effect and Helicobacter pylori.
        J Infect Dis. 1993; 168: 219-221
        • Webb P.M.
        • Forman D.
        Helicobacter pylori as a risk factor for cancer.
        Baillieres Clin Gastroenterol. 1995; 9: 563-582
        • Sipponen P.
        • Kosunen T.U.
        • Valle J.
        • et al.
        Helicobacter pylori infection and chronic gastritis in gastric cancer.
        J Clin Pathol. 1992; 45: 319-323
        • Kikuchi S.
        • Wada O.
        • Nakajima T.
        • et al.
        Serum anti-Helicobacter pylori antibody and gastric carcinoma among young adults.
        Cancer. 1995; 75: 2789-2793
        • Asaka M.
        • Kimura T.
        • Kato M.
        • et al.
        Possible role of Helicobacter pylori infection in early gastric cancer development.
        Cancer. 1994; 73: 2691-2694
        • Lin J.T.
        • Wang J.T.
        • Wang T.H.
        • et al.
        Helicobacter pylori infection in a randomly selected population, healthy volunteers, and patients with gastric ulcer and gastric adenocarcinoma. A seroprevalence study in Taiwan.
        Scand J Gastroentol. 1993; 28: 1067-1072
        • Kuipers E.J.
        • Gracia-Casanova M.
        • Pena A.S.
        • et al.
        Helicobacter pylori serology in patients with gastric carcinoma.
        Scand J Gastroenterol. 1993; 28: 433-437
        • Talley J.N.
        • Zinsmeister A.R.
        • Weaver A.
        • et al.
        Gastric adenocarcinoma and Helicobacter pylori infection.
        J Natl Cancer Inst. 1991; 83: 1734-1739
        • Hansson L.E.
        • Engstrand L.
        • Nyren O.
        • et al.
        Helicobacter pylori infection.
        Gastroenterology. 1993; 105: 1098-1103
        • Parsonnet D.M.
        • Friedman G.T.
        • Vandersteen D.P.
        • et al.
        Helicobacter pylori infection and the risk of gastric cancer.
        N Engl J Med. 1991; 325: 1127-1131
        • Nomura A.
        • Stemmernamn G.N.
        • Chyou P.H.
        • et al.
        Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii.
        N Engl J Med. 1991; 325: 1132-1136
        • Forman D.
        • Newell D.G.
        • Fullerton F.
        • Yarnell J.W.
        • Stacey A.R.
        • Wald N.
        • et al.
        Association between infection with Helicobacter pylori and risk of gastric cancer; evidence of a prospective investigation.
        BMJ. 1991; 302: 1302-1305
        • Nomura A.M.Y.
        • Stemmermann G.N.
        • Chyou P.-H.
        Gastric cancer among the Japanese in Hawaii.
        Jpn J Cancer Res. 1995; 86: 916-923
        • Forman D.
        • Webb P.
        • Parsonnet J.
        Helicobacter pylori and gastric cancer.
        Lancet. 1994; 343: 243-244
        • Danesh J.
        Helicobacter pylori and gastric cancer; systematic review of epidemiological studies.
        Aliment Pharmacol Ther. 1999; 13: 851-856
        • Eslick G.D.
        • Lim L.L.
        • Byles J.E.
        • et al.
        Association of Helicobacter pylori infection with gastric carcinoma.
        Am J Gastroenterol. 1999; 94: 2373-2379
        • Siman J.H.
        • Forsgren A.
        • Berglund G.
        • et al.
        Association between Helicobacter pylori and gastric carcinoma in the city of Malmo, Sweden. A prospective study.
        Scand J Gastroenterol. 1997; 32: 1215-1221
        • Kuipers E.J.
        • Uyterlinde A.M.
        • Pena A.S.
        • et al.
        Long-term sequelae of Helicobacter pylori gastritis.
        Lancet. 1995; 345: 1525-1528
        • Valle J.
        • Kekki M.
        • Sipponen P.
        • et al.
        Long-term course and consequences of Helicobacter pylori gastritis. Results of a 32 year follow up study.
        Scand J Gastroenterol. 1996; 31: 546-550
        • Siurala M.
        • Sipponen P.
        • Kekki M.
        Chronic gastritis.
        Scand J Gastroenterol. 1985; 109: S69-S76
        • Sipponen P.
        Atrophic gastritis as a premalignant condition.
        Ann Med. 1989; 21: 287-290
        • Sipponen P.
        • Riihela M.
        • Hyvarinen H.
        • et al.
        Chronic nonatrophic (“superficial”) gastritis increases the risk of gastric carcinoma. A case–control study.
        Scand J Gastroenterol. 1994; 29: 336-340
        • Sipponen P.
        • Kekki M.
        • Haapakoski J.
        • et al.
        Gastric cancer risk in chronic atrophic gastritis.
        Int J Cancer. 1985; 35: 173-177
        • Parsonnet J.
        • Friedman D.G.
        • Orentreich N.
        • Vogelman II,
        Risk of gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection.
        Lancet. 1997; 40: 297-301
        • Ponzetto A.
        • Soldati T.
        • deGuili M.
        Helicobacter pylori screening and gastric cancer (letter).
        Lancet. 1996; 348: 758
        • Isaacson P.G.
        Gastric lymphoma and Helicobacter pylori.
        N Engl J Med. 1994; 330: 1310-1311
        • Isaacson P.G.
        Recent developments in our understanding of gastric lymphomas.
        Am J Surg Pathol. 1996; 20: S1-S7
        • Wotherspoon A.C.
        • Ortiz-Hidalgo C.
        • Falzon M.R.
        • et al.
        Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma.
        Lancet. 1991; 338: 1175-1176
        • Parsonnet J.
        • Hansen S.
        • Rodriguez L.
        • et al.
        Helicobacter pylori infection and gastric lymphoma.
        N Engl J Med. 1994; 330: 1267-1271
        • Wotherspoon A.C.
        • Doglioni C.
        • Diss T.C.
        • et al.
        Regression of primary low-grade B-cell lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori.
        Lancet. 1993; 342: 575-577
        • Bayerdorffer E.
        • Neubauer A.
        • Rudolph B.
        • et al.
        Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection.
        Lancet. 1995; 345: 1591-1594
        • Cammarota G.
        • Montalto M.
        • Tursi A.
        • et al.
        Helicobacter pylori reinfection and rapid relapse of low-grade B-cell gastric.
        Lancet. 1995; 345: 192
        • Stalnikowicz R.
        • Benbassat J.
        Risk of gastric cancer after gastric surgery for benign disorders.
        Arch Intern Med. 1990; 150: 2022-2026
        • Tersmette A.C.
        • Giardiello F.M.
        • Tytgat G.N.
        • et al.
        Carcinogenesis after remote peptic ulcer surgery.
        Scand J Gastroenterol. 1995; 212 (S): 96-99
        • Fisher S.G.
        • Davis F.
        • Nelson R.
        • et al.
        A cohort study of stomach cancer risk in men after gastric surgery for benign disease.
        J Natl Cancer Inst. 1993; 85: 1303-1310
        • Tersmette A.C.
        • Offerhaus G.J.
        • Tersmette K.W.
        • et al.
        Meta-analysis of the risk of gastric stump cancer.
        Cancer Res. 1990; 50: 6486-6489
        • Molloy R.M.
        • Sonnenberg A.
        Relation between gastric cancer and previous peptic ulcer disease.
        Gut. 1997; 40: 247-252
        • Lee S.
        • Iida M.
        • Yao T.
        • et al.
        Risk of gastric cancer in patients with non-surgically treated peptic ulcer.
        Scand J Gastroenterol. 1990; 25: 1223-1226
        • Hansson L.E.
        • Nyren O.
        • Hsing A.W.
        • et al.
        The risk of stomach cancer in patients with gastric or duodenal ulcer disease.
        N Engl J Med. 1996; 335: 242-249
        • Hole D.J.
        • Quigley E.M.
        • Gillis C.R.
        • et al.
        Peptic ulcer and cancer.
        Scand J Gastroenterol. 1987; 22: 17-23
        • Parsonnet J.
        Helicobacter pylori in the stomach—a paradox unmasked.
        N Engl J Med. 1996; 335: 278-280
        • Uemura N.
        • Okamoto S.
        • Yamamoto S.
        • et al.
        Helicobacter pylori infection and the development of gastric cancer.
        N Engl J Med. 2001; 345: 784-789
        • Kono S.
        • Hirohata T.
        Nutition and stomach cancer.
        Cancer Causes Control. 1996; 7: 41-55
        • Neugut A.I.
        • Hayek M.
        • Howe G.
        Epidemiology of gastric cancer.
        Semin Oncol. 1996; 23: 281-291
        • Blot W.J.
        • Li J.Y.
        • Taylor P.R.
        • et al.
        Nutrition intervention trials in Linxian, China.
        J Natl Cancer Inst. 1993; 85: 1483-1491
        • Joossens J.V.
        • Hill M.J.
        • Elliott P.
        • et al.
        Dietary salt, nitrate and stomach cancer mortality in 24 countries.
        Int J Epidemiol. 1996; 24: 494-504
        • Lee J.K.
        • Park B.J.
        • Yoo K.Y.
        • et al.
        Dietary factors and stomach cancer.
        Int J Epidemiol. 1995; 24: 33-41
        • Hansson L.E.
        • Nyren O.
        • Bergstrom R.
        • et al.
        Diet and risk of gastric cancer. A population-based case–control study in Sweden.
        Int J Cancer. 1993; 55: 181-189
        • Ramon J.M.
        • Serra L.
        • Cerdo C.
        • et al.
        Dietary factors and gastric cancer risk. A case–control study in Spain.
        Cancer. 1993; 71: 1731-1735
        • Boeing H.
        • Jedrychowski W.
        • Wahrendorf J.
        • et al.
        Dietary risk factors in intestinal and diffuse types of stomach cancer.
        Cancer Causes Control. 1991; 2: 227-233
        • Graham S.
        • Haughey B.
        • Marshall J.
        • et al.
        Diet in the epidemiology of gastric cancer.
        Nutr Cancer. 1990; 13: 19-34
        • Buiatti E.
        • Palli D.
        • Decarli A.
        • et al.
        A case–control study of gastric cancer and diet in Italy.
        Int J Cancer. 1989; 44: 611-616
        • Kono S.
        • Hirohata T.
        Nutrition and stomach cancer.
        Cancer Causes Control. 1996; 7: 41-55
        • Buiatti E.
        • Palli D.
        • Decarli A.
        • et al.
        A case–control study of gastric cancer and diet in Italy. II. Association with nutrients.
        Int J Cancer. 1990; 45: 896-901
        • Gonzalez C.A.
        • Riboli E.
        • Badosa J.
        • et al.
        Nutritional factors and gastric cancer in Spain.
        Am J Epidemiol. 1994; 139: 466-473
        • La Vecchia C.
        • Ferraroni M.
        • D'Avanzo B.
        • et al.
        Selected micronutrient intake and the risk of gastric cancer.
        Cancer Epidemiol Biomarkers Prev. 1994; 3: 393-398
        • Hansson L.E.
        • Nyren O.
        • Bertstrom R.
        • et al.
        Nutrients and gastric cancer risk. A population-based case–control study in Sweden.
        Int J Cancer. 1994; 57: 638-644
        • Dixon M.E.
        Commentary.
        Gastroenterology. 1997; 113: 565-566
        • Thompson D.E.
        • Mabuchi K.
        • Ron E.
        • et al.
        Cancer incidence in atomic bomb survivors. Part II.
        Radiat Res. 1994; 137: S17-S67
        • Griem M.L.
        • Kleinerman R.A.
        • Boice Jr, J.D.
        • et al.
        Cancer following radiotherapy for peptic ulcer.
        J Natl Cancer Inst. 1994; 86: 842-849
        • Moller H.
        • Mellemgaard A.
        • Jacobsen G.K.
        • et al.
        Incidence of second primary cancer following testicular cancer.
        Eur J Cancer. 1993; 29A: 672-676
        • van Leeuwen F.E.
        • Stiggelbout A.M.
        • van den Belt-dusebout A.W.
        • et al.
        Second cancer risk following testicular cancer.
        J Clin Oncol. 1993; 11: 415-424
        • Wang J.-X.
        • Inskip P.D.
        • Boice J.D.
        • et al.
        Cancer Incidence among medical diagnostic X-ray workers in China, 1950 to 1985.
        Int J Cancer. 1990; 45: 889-895
        • Smith P.G.
        • Doll R.
        Mortality from cancer and all causes among British radiologist.
        Br J Radiol. 1981; 54: 187-194
        • Matanoski G.M.
        • Seltser R.
        • Sartwell P.E.
        • et al.
        The current mortality rates of radiologists and other physician specialists.
        Am J Epidemiol. 1975; 101: 199-210
        • Hsing A.
        • Hansson L.
        • McLaughlin J.
        • et al.
        Pernicious anaemia and subsequent cancer.
        Cancer. 1993; 71: 745-750
        • Hansson L.E.
        • Baron J.
        • Nyren O.
        • et al.
        Tobacco, alcohol and the risk of gastric cancer. A population-based case–control study in Sweden.
        Int J Cancer. 1994; 57: 26-31
        • Nomura A.
        • Grove J.
        • Stemmermann G.
        • et al.
        A prospective study of stomach cancer and its relation to diet, cigarettes and alcohol consumption.
        Cancer Res. 1990; 50: 627-631
        • Engeland A.
        • Andersen A.
        • Haldorsen T.
        • et al.
        Smoking habits and risk of cancers other than lung cancer.
        Cancer Causes Control. 1996; 7: 497-506
        • Doll R.
        • Peto R.
        • Wheatley K.
        • et al.
        Mortality in relation to smoking.
        BMJ. 1994; 309: 901-911
        • McLaughlin J.K.
        • Hrubec Z.
        • Blot W.J.
        • et al.
        Smoking and cancer mortality among US Veterans.
        Int J Cancer. 1995; 60: 190-193
        • Ji B.T.
        • Chow W.H.
        • Yang G.
        • et al.
        The influence of cigarette smoking, alcohol, and green tea consumption of the risk of carcinoma of the cardia and distal stomach in Shanghai.
        China. Cancer. 1996; 77: 2449-2457
        • Jedrychowski W.
        • Boeing H.
        • Wahrendorf J.
        • et al.
        Vodka consumption, tobacco smoking and risk of gastric cancer in Poland.
        Int J Epidemiol. 1993; 22: 606-613
        • Kabat G.C.
        • Ng S.K.
        • Wynder E.L.
        Tobacco, alcohol intake, and diet in relation to adenocarcinoma of the esophagus and gastric cardia.
        Cancer Causes Control. 1993; 4: 123-132
        • Vaughan T.L.
        • Davis S.
        • Kristal A.
        • et al.
        Obesity, alcohol, and tobacco as risk factors for cancers of the esophagus and gastric cardia.
        Cancer Epidemiol Biomarkers Prev. 1995; 4: 85-92
        • Gammon M.D.
        • Schoenberg J.B.
        • Ahsan H.
        • et al.
        Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia.
        J Natl Cancer Inst. 1997; 89: 1277-1284
        • Unakami M.
        • Hara M.
        • Fukuchi S.
        • et al.
        Cancer of the gastric cardia and the habit of smoking.
        Acta Pathol Jpn. 1989; 39: 420-424
        • Franceschi S.
        • La Vecchia C.
        Alcohol and the risk of cancers of the stomach and colon-rectum.
        Dig Dis. 1994; 12: 276-289
        • Palli D.
        • Bianchi S.
        • Decarli A.
        • et al.
        A case–control study of cancers of the gastric cardia in Italy.
        Br J Cancer. 1992; 65: 263-266
        • Guo W.
        • Blot W.J.
        • Li J.Y.
        • et al.
        A nested case–control study of oesophageal and stomach cancers in the Linzian nutrition intervention trial.
        Int J Epidemiol. 1994; 23: 444-450
        • Gray J.R.
        • Coldman A.J.
        • MacDonald W.C.
        Cigarette and alcohol use in patients with adenocarcinoma of the gastric cardia or lower esophagus.
        Cancer. 1992; 69: 2227-2231
        • Frumkin H.
        • Berlin J.
        Asbestos exposure and gastrointestinal malignancy—review and meta-analysis.
        Am J Indust Med. 1988; 14: 79-95
        • Cocco P.
        • Palli D.
        • Buiatti E.
        • et al.
        Occupational exposures as risk factors for gastric cancer in Italy.
        Cancer Causes Control. 1994; 5: 241-248
        • Zandjani F.
        • Hogsaet B.
        • Andersen A.
        • et al.
        Incidence of cancer among nitrate fertilizer workers.
        Int Arch Occup Environ Health. 1994; 66: 189-193
        • Andersen A.
        • Glattre E.
        • Johansen B.V.
        Incidence of cancer among lighthouse keepers exposed to asbestos in drinking water.
        Am J Epidemiol. 1993; 138: 682-687
        • de Klerk N.H.
        • Armstrong B.K.
        • Musk A.W.
        • et al.
        Cancer mortality in relation to measures of occupational exposure to crocidolite at Wittenoom Gorge in Western Australia.
        Br J Indust Med. 1989; 46: 529-536
        • Palli D.
        • Galli M.
        • Caporaso N.E.
        • et al.
        Family history and risk of stomach cancer in Italy.
        Cancer Epidemiol Biomarkers Prev. 1994; 3: 15-18
        • La Vechhia C.
        • Negri E.
        • Franchescki S.
        • et al.
        A family history and the risk of stomach and colorectal cancer.
        Cancer. 1992; 70: 50-55
        • Lissowska J.
        • Groves F.D.
        • Sobin L.H.
        • et al.
        Family history and risk of stomach cancer in Warsaw, Poland.
        Eur J Cancer Prev. 1999; 8: 223-227
        • Lichtenstein P.
        • Holm N.V.
        • Verkasald P.K.
        • et al.
        Environmental and heritable factors in the causation of cancer. Analysis of cohorts of twins from Sweden, Denmark and Finland.
        N Engl J Med. 2000; 343: 78-85
        • Kwiatkowski D.
        Susceptibility to infection.
        BMJ. 2000; 321: 1061-1065
        • Schlesseman J.J.
        Case–control studies. Design, conduct, analysis. Oxford University Press;, New York1982
        • Labenz J.
        • Blum A.
        • Bayerdorffer E.
        • et al.
        Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux oesophagitis.
        Gastroenterology. 1997; 112: 1442-1447