ABO blood group and risk of pancreatic cancer: a study in Shanghai and meta-analysis

Am J Epidemiol. 2013 Jun 15;177(12):1326-37. doi: 10.1093/aje/kws458. Epub 2013 May 6.

Abstract

Studies over 5 decades have examined ABO blood groups and risk of pancreatic cancer in Western, Asian, and other populations, though no systematic review has been published. We studied data from 908 pancreatic cancer cases and 1,067 population controls collected during December 2006-January 2011 in urban Shanghai, China, and reviewed the literature for all studies of this association. Random-effects meta-analysis provided summary odds ratio estimates according to blood group and by populations endemic versus nonendemic for cytotoxin-associated gene A (CagA)-positive Helicobacter pylori. In our Shanghai study, versus group O, only ABO group A was associated with risk (odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.27, 2.03). In 24 pooled studies, group A showed increased risk in both CagA-nonendemic and -endemic populations (ORpooled = 1.40, 95% CI: 1.32, 1.49). In nonendemic populations, groups B and AB were also associated with higher risk (OR = 1.38, 95% CI: 1.16, 1.64; and OR = 1.52, 95% CI: 1.24, 1.85, respectively). However, in CagA-endemic populations, groups B and AB were not associated with risk (OR = 1.05, 95% CI: 0.92, 1.19; and OR = 1.13, 95% CI: 0.92, 1.38, respectively). These population differences were significant. One explanation for contrasts in associations of blood groups B and AB between CagA-endemic and -nonendemic populations could involve gastric epithelial expression of A versus B antigens on colonization behaviors of CagA-positive and CagA-negative H. pylori strains.

Keywords: ABO blood group system; Asia; case-control studies; meta-analysis; pancreatic neoplasms.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • ABO Blood-Group System / blood*
  • Adult
  • Aged
  • Alleles
  • Antigens, Bacterial / genetics*
  • Asian People / statistics & numerical data*
  • Bacterial Proteins / genetics*
  • Case-Control Studies
  • China / epidemiology
  • Female
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / blood*
  • Pancreatic Neoplasms / epidemiology*
  • Phenotype
  • Polymorphism, Single Nucleotide
  • Risk Factors

Substances

  • ABO Blood-Group System
  • Antigens, Bacterial
  • Bacterial Proteins
  • cagA protein, Helicobacter pylori