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<jats:p>Helicobacter pylori infection is a major cause of non-cardia gastric cancer (NCGC), but uncertainty remains about the associations between sero-positivity to different H. pylori antigens and risk of NCGC and cardia gastric cancer (CGC) in different populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A case-cohort study in China included \u223c500 each of incident NCGC and CGC cases and \u223c2000 subcohort participants. Sero-positivity to 12 H. pylori antigens was measured in baseline plasma samples using a multiplex assay. Hazard ratios (HRs) of NCGC and CGC for each marker were estimated using Cox regression. These were further meta-analysed with studies using same assay.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the subcohort, sero-positivity for 12 H. pylori antigens varied from 11.4% (HpaA) to 70.8% (CagA). Overall, 10 antigens showed significant associations with risk of NCGC (adjusted HRs: 1.33 to 4.15), and four antigens with CGC (HRs: 1.50 to 2.34). After simultaneous adjustment for other antigens, positive associations remained significant for NCGC (CagA, HP1564, HP0305) and CGC (CagA, HP1564, HyuA). Compared with CagA sero-positive only individuals, those who were positive for all three antigens had an adjusted HR of 5.59 (95% CI 4.68\u20136.66) for NCGC and 2.17 (95% CI 1.54\u20133.05) for CGC. In the meta-analysis of NCGC, the pooled relative risk for CagA was 2.96 (95% CI 2.58\u20133.41) [Europeans: 5.32 (95% CI 4.05\u20136.99); Asians: 2.41 (95% CI 2.05\u20132.83); Pheterogeneity&amp;lt;0.0001]. Similar pronounced population differences were also evident for GroEL, HP1564, HcpC and HP0305. In meta-analyses of CGC, two antigens (CagA, HP1564) were significantly associated with a higher risk in Asians but not Europeans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Sero-positivity to several H. pylori antigens was significantly associated with an increased risk of NCGC and CGC, with varying effects between Asian and European populations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ije\/dyad007","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T19:33:53Z","timestamp":1678736033000},"page":"1197-1208","source":"Crossref","is-referenced-by-count":26,"title":["<i>Helicobacter pylori<\/i> multiplex serology and risk of non-cardia and cardia gastric cancer: a case-cohort study and meta-analysis"],"prefix":"10.1093","volume":"52","author":[{"given":"Pang","family":"Yao","sequence":"first","affiliation":[{"name":"Clinical Trial 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