Abstract
Background: Recently, very high Helicobacter pylori sero-prevalence rates were found among African Americans, especially those of higher percentage of African ancestry, residing in the southeastern US. We sought to determine if neighborhood-level socio-economic characteristics, above and beyond individual-level socio-economic characteristics, are associated with Helicobacter pylori prevalence, and, if so, if this helps to explain the strong association with African ancestry.
Methods: Antibodies to Helicobacter pylori proteins were assessed in the serum of 665 African American and white participants from the Southern Community Cohort Study. African and European admixture was estimated using a panel of 276 ancestry genetic markers. Prevalence odds ratios for CagA-specific Helicobacter pylori status associated with10 block-level measures of socio-economic status, obtained from linkage to the US Census, were calculated using polytomous logistic regression.
Results: After adjusting for individual-level socio-economic characteristics, three neighborhood-level characteristics were significantly inversely related to CagA+ Helicobacter pylori sero-positivity: percent adults completed high school; median value of owner-occupied houses; and percent employed (comparing highest tertile to lowest tertile, OR=0.47, 95%CI: 0.26–0.85; OR=0.56, 95% CI: 0.32–0.99; and OR=0.59, 95% CI: 0.34–1.03, respectively). However, inclusion of these neighborhood-level measures did not attenuate the association of African ancestry and CagA+ Helicobacter pylori sero-prevalence, with African Americans of low, medium, and high African ancestry maintaining 2-, 7-, and 9-fold increased odds compared to whites.
Neighborhood levels of education, house values, and employment are associated with sero-prevalence to CagA+Helicobacter pylori, highlighting high-risk areas for prevention and screening efforts, but the strong relationship between African ancestry level and CagA+ Helicobacter pylori sero-prevalence persisted after adjustment for individual and neighborhood-level socio-economic characteristics, suggesting a biological basis for this association.
Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A84.
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