RT Journal Article SR Electronic T1 High-Negative Anti–Helicobacter pylori IgG Antibody Titers and Long-Term Risk of Gastric Cancer: Results from a Large-Scale Population-Based Cohort Study in Japan JF Cancer Epidemiology Biomarkers & Prevention JO Cancer Epidemiol Biomarkers Prev FD American Association for Cancer Research SP 420 OP 426 DO 10.1158/1055-9965.EPI-19-0993 VO 29 IS 2 A1 Inoue, Manami A1 Sawada, Norie A1 Goto, Atsushi A1 Shimazu, Taichi A1 Yamaji, Taiki A1 Iwasaki, Motoki A1 Tsugane, Shoichiro YR 2020 UL http://cebp.aacrjournals.org/content/29/2/420.abstract AB Background: Serologic testing of anti–Helicobacter pylori antibody, together with testing of pepsinogen I and II, is now widely used to stratify groups at high risk of gastric cancer in Japan. Those with a negative anti–H. pylori IgG titer, especially “high-negative” (3–<10 U/mL), are speculated to have higher risk of gastric cancer. We aimed to evaluate the association between a high-negative anti–H. pylori IgG titer and the long-term risk of gastric cancer in the Japan Public Health Center-based Prospective Study (JPHC Study) Cohort II.Methods: The study population consisted of 19,106 Japanese men and women who were followed from 1993 to 2013. A Cox proportional hazards model was used to assess the risk of gastric cancer for plasma anti–H. pylori IgG titers, together with the severity of atrophic gastritis by pepsinogen I and II levels. A total of 595 cases of gastric cancer occurred during an average of 18 years of follow-up.Results: Compared with those with a low-negative anti–H. pylori IgG titer (≤3 U/mL), subjects with a high-negative titer (3–<10 U/mL) showed a significantly elevated risk of gastric cancer [HR = 2.81; 95% confidence interval (CI) = 1.62–4.89]. Among those with a high-negative titer, risk increase was observed under moderate or severe atrophic gastritis (HR = 18.73; 95% CI = 8.83–39.70).Conclusions: Our results suggest that those with a high-negative anti–H. pylori IgG titer and moderate and severe atrophic gastritis are at increased long-term risk of gastric cancer.Impact: Development of moderate or severe atrophic gastritis in subjects with high-negative anti–H. pylori IgG titer is suggested to increase risk of gastric cancer.