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The association between body mass index (BMI) and noncardia gastric cancer (NCGC) risk remains controversial. The purpose of our study was to examine the association of BMI with NCGC risk with consideration of Helicobacter pylori (HP) biomarkers. This international nested case–control study, composed of 1,591 incident NCGC cases and 1,953 matched controls, was established from eight cohorts in China, Japan and Korea, where the majority of NCGCs are diagnosed worldwide. HP antibody biomarkers were measured in blood collected at cohort enrollment by multiplex serology. The NCGC risk according to baseline BMI was estimated using logistic regression to produce odds ratios (ORs) and 95% confidence intervals (CIs). We found a U‐shaped association between BMI category and NCGC risk. Compared to those with reference BMI (22.6–25.0 kg/m2), those with lower and higher BMI had an increased NCGC risk (BMI <18.5 kg/m2, OR = 1.56, 95% CI = 1.04–2.34; BMI >27.5 kg/m2, OR = 1.48, 95% CI = 1.15–1.91; adjusted for age, sex and smoking). The U‐shaped association was persistent among subjects with HP infection and high‐risk biomarkers (HP+ CagA+: BMI <18.5 kg/m2, OR = 1.60, 95% CI = 1.00–2.55; BMI >27.5 kg/m2, OR = 1.59, 95% CI = 1.21–2.11; and Omp+ HP0305+: BMI <18.5 kg/m2, OR = 1.88, 95% CI = 1.04–3.42; BMI >27.5 kg/m2, OR = 1.70, 95% CI = 1.20–2.42, respectively). Our study provides evidence of significantly increased NCGC risk among individuals with low or high BMI, including in subjects with high‐risk HP biomarkers (HP+ CagA+, Omp+ HP0305+) in the high‐risk area of East Asia. What's new? Gastric‐cancer (GC) mortality in East Asian countries accounts for 58% of GC deaths worldwide. Does body mass index (BMI) affect GC risk in these populations? In this prospective study, the authors found a U‐shaped association between BMI and non‐cardia GC risk. This association also held true for subjects with high‐risk biomarkers for Helicobacter pylori infection. These results indicate that maintaining normal body weight is important for reducing gastric‐cancer risk in East Asia, which may help guide public health strategies. [ABSTRACT FROM AUTHOR]

Background: Epstein-Barr virus (EBV)-positive gastric cancers represent a distinct subtype of gastric cancers and account for nearly 10% of the gastric cancer burden, yet risk detection strategies for this cancer subtype are lacking.Methods: We conducted a nested case-control study where we assayed 4 EBV antigens [viral capsid antigen (VCA), early antigen (EA), Epstein-Barr nuclear antigen (EBNA), and BZLF1-encoded replication activator protein (ZEBRA)] in either sera or plasma from 1447 gastric cancer cases and 1797 controls obtained from seven prospective cohorts representing individuals from the high gastric cancer-risk countries of China, Japan, and Korea.Results: The prevalence of EBV sero-positivity was universal with the exception of one sero-negative individual, and the highest titers of the EBV antigens VCA (OR 0.95, 95% CI 0.78-1.17), EBNA (OR 0.88, 95% CI 0.72-1.08), EA (OR 0.97, 95% CI 0.79-1.19), and ZEBRA (OR 0.87, 95% CI 0.71-1.07) were not associated with risk of incident gastric cancer. When we stratified these data by H. pylori status, there was no change in the association.Conclusions: Multiplex serology of the aforementioned EBV antigens in serum may not be a suitable biomarker for predicting gastric cancer risk in East Asian populations. [ABSTRACT FROM AUTHOR]