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We aimed to examine the associations of <jats:italic>H. pylori<\/jats:italic> infection and gastric atrophy (defined using serum pepsinogen [PG] I to PGII ratio) with AEGJ risk, based on a population\u2010based case\u2010control study in Taixing, China (2010\u20102014), with 349 histopathologically confirmed AEGJ cases and 1859 controls. We explored the potential effect modification by <jats:italic>H. pylori<\/jats:italic> serostatus and sex on the association of serum PGs with AEGJ risk. We used unconditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). <jats:italic>H. pylori<\/jats:italic> seropositivity was associated with an elevated AEGJ risk (OR = 1.95, 95% CI: 1.47\u20102.63). Neither CagA\u2010positive nor VacA\u2010positive strains dramatically changed this association. Gastric atrophy (PGI\/PGII ratio \u22644) was positively associated with AEGJ risk (OR = 2.36, 95% CI: 1.72\u20103.22). The fully adjusted ORs for AEGJ progressively increased with the increasing levels of PGII (<jats:italic>P<\/jats:italic>\u2010trend &lt;.001). <jats:italic>H. pylori<\/jats:italic> showed nonsignificant effect modification (<jats:italic>P<\/jats:italic>\u2010interaction\u00a0=\u00a0.385) on the association of gastric atrophy with AEGJ. In conclusion, <jats:italic>H. pylori<\/jats:italic> and gastric atrophy were positively associated with AEGJ risk. These results may contribute evidence to the ongoing research on gastric atrophy\u2010related cancers and guide the prevention and control of AEGJ.<\/jats:p>","DOI":"10.1002\/ijc.33801","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T11:29:10Z","timestamp":1631186950000},"page":"243-252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Association of <scp><i>Helicobacter pylori<\/i><\/scp> and gastric atrophy with adenocarcinoma of the esophagogastric junction in Taixing, China"],"prefix":"10.1002","volume":"150","author":[{"given":"Peipei","family":"Gao","sequence":"first","affiliation":[{"name":"State Key Laboratory of Genetic Engineering Human Phenome Institute, School of Life Sciences, Fudan University  Shanghai China"},{"name":"Fudan University Taizhou Institute of Health Sciences  Taizhou 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