The contribution of Helicobacter pylori to excess gastric cancer in Indigenous and Pacific men: a birth cohort estimate

The reasons for higher gastric cancer incidence rates in indigenous populations are debated. We quantify the role of Helicobacter pylori in excess gastric cancer incidence in MAori and Pacific men in New Zealand. Age-standardized gastric cancer rate ratios for 1981-2004 were calculated in MAori and Pacific men compared with European/other men born in 1926-1940 and in 1941-1955. Rate ratios were then compared with those restricted to H. pylori prevalent populations. H. pylori contributed substantially to excess gastric cancer incidence in MAori men (50%, 61%) and Pacific men (71%, 82%) in both cohorts. Policy should focus on reducing the acquisition and prevalence of H. pylori infection in these populations.