The risk of gastric cancer: genetic polymorphisms, Helicobacter pylori virulence factors and lifestyle.

In the Netherlands the incidence of gastric cancer is approximately 2000 cases
per year. Patients with gastric cancer usually present at advanced stage, with
only limited treatment options. The detection of lesions at high risk of
malignant transformation or early gastric cancer at a curable stage would
improve morbidity and survival.
However, a population screening program of gastric cancer does not seem
appropriate in a country with a relatively low incidence. To identify risk
groups that might benefit from screening and surveillance, risk factors for the
development of gastric cancer need to be identified.
The risk of gastric cancer for each individual is presumably largely determined
by the interaction between host genetic factors, Helicobacter pylori virulence
and lifestyle.

Primary objective:
To determine the relative risk of gastric cancer for genetic polymorphisms.

Secondary objectives:
- To determine the relative risk of gastric cancer for combinations of genetic
polymorphisms, H. pylori virulence factors and lifestyle factors.
- To determine whether susceptibility to H. pylori infection is influenced by
host genetic polymorphisms.

Multicenter case-control study. Risk profiles from patients suffering from
gastric cancer will be compared with profiles from a control-group of patients
scheduled for gastroscopy.
All patients will be asked to fill out a questionnaire. From both gastric
cancer patients and control patients, eight gastric biopsies will be collected.
The gastric biopsies will be used to investigate genetic polymorphisms and H.
pylori virulence factors.

Complications resulting from gastroscopies are rare (about 1 per 3000
gastroscopies), possible complications are bleeding or perforation. The burden
of a gastroscopy is usually limited. After participation in this study the
participants can directly leave the hospital.