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Moreover, while germline pathogenic variants may modify the association between\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    infection and gastric cancer risk, their roles in BTC and PC are unclear. We examined these associations while accounting for genetic susceptibility and lifestyle factors. Two case\u2013control studies were conducted, including 116 BTC cases, 417 PC cases, and 3086 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression adjusted for age, sex, study version, carrier status of pathogenic variants, smoking, and alcohol consumption.\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    infection was defined by antibody seropositivity, pepsinogen\u2010based atrophic gastritis (AG), and their combination. Subsite\u2010specific analyses were also performed. No significant association was observed between\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    infection and BTC risk. However, higher\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    antibody titers (per 10\u2009U\/mL increase) were positively associated with overall PC risk (OR 1.04, 95% CI: 1.01\u20131.07). In subsite analyses, AG without detectable antibodies was positively associated with pancreatic head cancer risk (OR 3.04, 95% CI: 1.23\u20137.54), whereas\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    seropositivity was positively associated with pancreatic body cancer risk (OR 1.75, 95% CI: 1.10\u20132.77). No interaction between\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    infection and pathogenic variants, smoking, or alcohol consumption was observed for either cancer. These findings suggest that\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    infection may be associated with pancreatic cancer risk in specific anatomical regions, with limited evidence for modification by genetic or lifestyle factors.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70652","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T04:31:41Z","timestamp":1784089901000},"page":"2720-2735","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Helicobacter pylori<\/i>\n                    Infection and the Risk of Biliary Tract and Pancreatic Cancers: Subsite\u2010Specific Associations in a Japanese 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