Skip to main content
Download PDF

ABO genotypes and the risk of esophageal and gastric cancers

BMC Cancer volume 21, Article number: 589 (2021) Cite this article

Abstract

Background

Blood type has been associated with the risk of gastric cancer, but few studies have examined the association with esophageal squamous cell carcinoma (ESCC).

Methods

We conducted a case-control study using genotyping data of Chinese individuals, including cases of 2022 ESCC, 1189 gastric cardia adenocarcinoma, 1161 gastric noncardia adenocarcinoma, and 2696 controls. Genetic blood type was imputed using three single nucleotide polymorphisms. We used logistic regression to examine the association between blood type and the risk of each cancer.

Results

Compared to blood type O, the risk of ESCC was significantly elevated for blood type B and AB, with the highest risk for type AB (OR, 95%CI: 1.34, 1.07–1.67). Analysis of genotype suggested that the association of ESCC was from carrying the B allele. Similarly, blood type was significantly associated with gastric noncardia adenocarcinoma (P < 0.001) with risk significantly elevated in type A (1.37, 1.14–1.65) and AB (1.44, 1.10–1.89) compared to type O. Blood type was not associated with gastric cardia adenocarcinoma (P = 0.13).

Conclusions

This study provides novel insights into the association between blood type and the risk of ESCC and restricted previously observed association to only gastric noncardia cancer, providing important evidence to clarify the pattern of association and suggesting mechanisms of action.

Peer Review reports

Background

As early as the 1950s [1], blood type A was reported to be associated with an increased risk of gastric cancer [2]. Advances in genotyping technology have allowed for a more thorough interrogation of the effect of each allele from the ABO locus. A case-control study using genotyping data from a Japanese population found an increased risk of gastric cancer from carrying the A allele and a decrease in risk from carrying the B allele [3]. Recently, both epidemiologic and genome-wide association studies have demonstrated distinct patterns for gastric cancer when the stomach is divided into the cardia (the most proximal few centimeters of the organ) and the noncardia (the remainder of the stomach) [4,5,6], suggesting a need for separating gastric cancer by anatomic subsite in etiologic studies.

Despite a long history of research in gastric cancer, few studies have examined the association between ABO blood type and the risk of esophageal cancer [7,8,9]. One recent case-control study of 480 patients with esophageal squamous cell carcinoma (ESCC) and 480 controls suggested a higher frequency of blood type B in patients with ESCC [10]. However, the study was limited by a relatively small sample size and no replication study to validate the findings.

The aim of the current study was to evaluate the association between ABO blood type and the risk of three upper gastrointestinal cancers—ESCC, gastric cardia adenocarcinoma, and gastric noncardia adenocarcinoma—using genotyping data from five epidemiologic studies of subjects of Chinese ethnicity. Examination of the association between ABO blood type and each of the three upper gastrointestinal cancer sites will provide important evidence to clarify the pattern of association.

Methods

The study consisted of five distinct study populations of Chinese ethnicity that have been described in detail previously [11,12,13,14,15]. These five studies include a large neighborhood-based case-control study (the Shanxi UGI Cancer Genetics Project); and nested groups from four cohort studies: the Linxian Nutrition Intervention Trial, the Shanghai Men’s Health Study, the Shanghai Women’s Health Study, and the Singapore Chinese Health Study. In the current study, we used GWAS data from the five studies [16], which totaled 2022 ESCC cases, 1189 gastric cardia adenocarcinoma, 1161 gastric noncardia adenocarcinomas, and 2696 control subjects.

Single nucleotide polymorphism selection and genotyping

The methods of genotyping have been described in detail elsewhere [16, 17]. In summary, genome-wide scanning was performed using the Illumina 660 W array. We excluded SNPs with a missing rate > 5%; subjects with a completion rate of all SNPs < 94%; subjects with abnormal mean heterozygosity values (> 30% or < 25%); gender discordant subjects; or unexpected duplicate pairs [17]. To determine blood type from the SNPs, we first used PHASE [18] to infer haplotypes for rs505922, rs8176746, and rs574347, which provided two ABO alleles for each subject [19]. Each subject has two ABO alleles contributing to six genotypes, OO, AO, AA, AB, BO, and BB. Phenotypes were determined based on the dominance of the A and B alleles over the O allele. We then used phenotype and genotype data in our subsequent statistical analyses. The fourth SNP that marks the A2 allele, rs8176704, was nearly monomorphic (MAF < 0.5%) in our study population, and therefore was excluded from analysis.

Statistical analysis

We used logistic regression models to examine the association between blood type and the risk of the three cancers. All regression results, except the study stratified models, were from models conditioned on study, though we note that this conditioning had little effect on the results in either crude or multivariable adjusted models (data not shown). We adjusted the models for age (in three categories: < 50 years, 50–59 years, and ≥ 60 years), sex, tobacco smoking (never and ever), and alcohol drinking (never and ever). P-values were calculated using the difference in − 2 log likelihood of nested models and the chi-square distribution with appropriate degrees of freedom. We used an alpha of 0.05 without correction for multiple comparisons for two reasons: 1) a small number of association tests for each cancer outcome; and 2) a strong prior association for gastric cancers.

To address potential differences in associations by strata across the five study populations, we used a meta-analysis framework to minimize the effect of heterogeneity. We firstly conducted unconditional logistic regressions to estimate the Odds Ratios (ORs) of the blood type and risk of the three cancers by each individual study population. We then used study specific ORs from unconditional logistic regression models to calculate random effects meta-estimates via the metan command group in Stata version 11. The remainder of the analysis was conducted using SAS version 9.

Results

Table 1 presents the characteristics of 2696 control subjects by blood type. Overall, about three-quarters of controls were blood type O (33.0%), follow by blood type B (31.6%) and A (26.9%). Only 8.5% controls were blood type AB.

Table 1 Characteristics by imputed ABO blood typesa in 2696 control subjects
Full size table

Table 2 presents the distribution of blood types, stratified by study. We observed evidence for a significant heterogeneity in blood type distributions across studies (P = 0.004). Compared with the other four studies, the distribution in the Singapore cohort was distinctly different, with a lower proportion of blood type AB (4.4%) and a higher proportion of blood type O (41.9%).

Table 2 Distribution of ABO blood types in control subjects by study
Full size table

Table 3 shows the proportions of blood type and crude and adjusted odds ratios (aOR) for the risk of ESCC, gastric cardia adenocarcinoma, and gastric noncardia adenocarcinoma. Compared to controls, blood type had significantly different distributions for ESCC (P = 0.003) and gastric noncardia adenocarcinoma (P = 0.001), but not for gastric cardia adenocarcinoma (P = 0.39). For ESCC, blood types B (aOR, 95%CI: 1.19, 1.02–1.38) and AB (aOR, 95%CI: 1.34, 1.07–1.67) had significantly increased risk compared to blood type O. For gastric noncardia adenocarcinoma, compared to blood type O, the risk was significantly increased in blood types A (aOR, 95%CI: 1.37, 1.14–1.65) and AB (aOR, 95%CI: 1.44, 1.10–1.89) (Table 3).

Table 3 Distribution of imputed ABO blood typesa and the risk of upper gastrointestinal cancer
Full size table

To further explore the observed associations, we classified subjects by genotype (Table 4). For ESCC, the association of ESCC was from carrying the B allele without allele dose response observed. For noncardia gastric adenocarcinoma, carriage of an A allele in any combination was the primary contributor to the increased risk, but again no allele dose response was evident (Table 4).

Table 4 Riska of upper gastrointestinal cancer by genotype
Full size table

Discussion

In the current study, we found common and distinct patterns of association between blood type and three upper gastrointestinal cancers in ethnic Chinese populations. Compared to blood type O, blood type AB was associated with the highest risk of ESCC and gastric noncardia adenocarcinoma. Analysis of alleles suggested that the ESCC association was from carrying the B allele, with genotypes AB and BB having the highest risk compared to genotype OO. For gastric noncardia adenocarcinoma, the association was from the carriage of one A alleles. However, blood type (i.e. phenotype) or allele associations were not observed for gastric cardia adenocarcinoma.

Few studies have examined the association between blood type and the risk of esophageal cancer. Previously, a study of Japanese ESCC patients and controls found a higher frequency of the B antigen among ESCC patients [10]. In the current study, we showed that all non-O blood types had increased risk of ESCC relative to blood type O, but the strongest risk was associated with a carriage of the B allele, specifically by genotypes AB and BB.

The association between blood type and gastric cancer has been widely studied [2, 20]. In this study we confirmed a significantly increased risk of carrying an A allele for gastric noncardia adenocarcinoma, regardless of the second allele (O, or B). Hypothesized mechanisms include physiological differences related to blood type A that mediate the alterations in systemic inflammatory state, intercellular adhesion and membrane signaling, and immune surveillance for malignant cell [21]. In addition, a Chinese case-control study and meta-analysis showed that gastric cancer patients with blood type A had a higher likelihood of Helicobacter pylori infections than patients with other blood types, suggesting more frequent infections or greater inflammations in response to infections related to blood type A [22].

Unexpectedly, neither blood type nor allele was associated with gastric cardia adenocarcinoma. This observation is in contrast to previous studies that have shown that in China, gastric cardia adenocarcinoma and ESCC share many risk factors [23] including multiple genetic risk factors [16, 24]. Gastric cardia and noncardia adenocarcinoma have also been observed to share multiple genetic and nongenetic factors that are distinct from the esophagus, for example, H. pylori and serum pepsinogens [25, 26]. Neither of these patterns, however, was observed in the current study of blood types, where we found distinct associations with ESCC and gastric noncardia adenocarcinoma but no association with gastric cardia adenocarcinoma. These findings were unlikely to be due to low statistical power for gastric cardia adenocarcinoma, as we had equally large numbers of cases for both gastric cardia (n = 1189) and noncardia (n = 1161) adenocarcinomas.

Our study has some strengths and limitations. We used an existing dataset that previously identified multiple validated significant associations between ESCC, gastric cardia or noncardia adenocarcinoma and numerous SNPs [16, 17]. A large sample size provided good power overall and the genetic data allowed for an investigation of the underlying genotype, in addition to phenotype. However, a lack of data on H. pylori for the full dataset limited insights into this potential disease-associated mechanism, although we note that H. pylori infection in our study population is relatively high in controls (92%) [27], leaving little variation in exposure. Moreover, we were not able to conduct re-review of case identification within the study as well as across studies, and therefore were not able to comment on possible misclassification of gastric cardia and noncardia adenocarcinoma in the studies. Additionally, the distribution of blood type in the Singapore cohort was notably different compared with the blood type distribution in the other four populations, though sensitivity analysis excluding the Singapore population did not alter our results (data not shown). Finally, secretor status has been shown to reportedly modify the cancer risk conferred by ABO blood type [28, 29]. In this study we did not have genotype information on the rare alleles that may confer negative secretor status in people of Chinese descent [30]. We did, however, conduct a sensitivity analysis extracting all available SNPs (N = 11) in the FUT2 gene, a functional FUT2 allele being required for secretion, from our GWAS data to test whether these singly or collectively altered the association with ABO SNPs. They did not alter our results (data not shown).

Conclusion

In conclusion, our results validate a previously reported association between blood type and the risk of gastric adenocarcinoma and extended this observation to show that the association was restricted to only gastric noncardia adenocarcinoma. In addition, we found a significantly increased risk for ESCC conveyed by the carriage of the B allele. Functional investigations are warranted to elucidate the mechanisms of ABO blood groups behind these associations.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ESCC:

Esophageal squamous cell carcinoma

OR:

Odds ratio

References

  1. Aird I, Bentall HH, Roberts JA. A relationship between cancer of stomach and the ABO blood groups. Br Med J. 1953;1(4814):799–801. https://doi.org/10.1136/bmj.1.4814.799.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Edgren G, Hjalgrim H, Rostgaard K, Norda R, Wikman A, Melbye M, et al. Risk of gastric cancer and peptic ulcers in relation to ABO blood type: a cohort study. Am J Epidemiol. 2010;172(11):1280–5. https://doi.org/10.1093/aje/kwq299.

    Article  PubMed  Google Scholar 

  3. Nakao M, Matsuo K, Ito H, Shitara K, Hosono S, Watanabe M, et al. ABO genotype and the risk of gastric cancer, atrophic gastritis, and helicobacter pylori infection. Cancer Epidemiol Biomark Prev. 2011;20(8):1665–72. https://doi.org/10.1158/1055-9965.EPI-11-0213.

    Article  Google Scholar 

  4. Lindblad M, Rodriguez LA, Lagergren J. Body mass, tobacco and alcohol and risk of esophageal, gastric cardia, and gastric non-cardia adenocarcinoma among men and women in a nested case-control study. Cancer Causes Control. 2005;16(3):285–94. https://doi.org/10.1007/s10552-004-3485-7.

    Article  PubMed  Google Scholar 

  5. Hu N, Wang Z, Song X, Wei L, Kim BS, Freedman ND, et al. Genome-wide association study of gastric adenocarcinoma in Asia: a comparison of associations between cardia and non-cardia tumours. Gut. 2016;65(10):1611–8. https://doi.org/10.1136/gutjnl-2015-309340.

    Article  CAS  PubMed  Google Scholar 

  6. Gupta S, Tao L, Murphy JD, Camargo MC, Oren E, Valasek MA, et al. Race/ethnicity-, socioeconomic status-, and anatomic subsite-specific risks for gastric cancer. Gastroenterology. 2019;156(1):59–62.e4.

    Article  PubMed  Google Scholar 

  7. Aird I, Lee DR, Roberts JA. ABO blood groups and cancer of oesophagus, cancerof pancreas, and pituitary adenoma. Br Med J. 1960;1(5180):1163–6. https://doi.org/10.1136/bmj.1.5180.1163.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Wapnick S, Zanamwe LN, Chitiyo M, Mynors JM. Cancer of the esophagus in Central Africa. Chest. 1972;61(7):649–54. https://doi.org/10.1378/chest.61.7.649.

    Article  CAS  PubMed  Google Scholar 

  9. Su M, Lu SM, Tian DP, Zhao H, Li XY, Li DR, et al. Relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China. World J Gastroenterol. 2001;7(5):657–61. https://doi.org/10.3748/wjg.v7.i5.657.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Kumar N, Kapoor A, Kalwar A, Narayan S, Singhal MK, Kumar A, et al. Allele frequency of ABO blood group antigen and the risk of esophageal cancer. Biomed Res Int. 2014;2014:286810.

    PubMed  PubMed Central  Google Scholar 

  11. Qiao YL, Dawsey SM, Kamangar F, Fan JH, Abnet CC, Sun XD, et al. Total and cancer mortality after supplementation with vitamins and minerals: follow-up of the Linxian general population nutrition intervention trial. J Natl Cancer Inst. 2009;101(7):507–18. https://doi.org/10.1093/jnci/djp037.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Gao Y, Hu N, Han XY, Ding T, Giffen C, Goldstein AM, et al. Risk factors for esophageal and gastric cancers in Shanxi province, China: a case-control study. Cancer Epidemiol. 2011;35(6):e91–9. https://doi.org/10.1016/j.canep.2011.06.006.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Shu XO, Li H, Yang G, Gao J, Cai H, Takata Y, et al. Cohort profile: the Shanghai men’s health study. Int J Epidemiol. 2015;44(3):810–8. https://doi.org/10.1093/ije/dyv013.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Zheng W, Chow WH, Yang G, Jin F, Rothman N, Blair A, et al. The Shanghai women’s health study: rationale, study design, and baseline characteristics. Am J Epidemiol. 2005;162(11):1123–31. https://doi.org/10.1093/aje/kwi322.

    Article  PubMed  Google Scholar 

  15. Hankin JH, Stram DO, Arakawa K, Park S, Low SH, Lee HP, et al. Singapore Chinese health study: development, validation, and calibration of the quantitative food frequency questionnaire. Nutr Cancer. 2001;39(2):187–95. https://doi.org/10.1207/S15327914nc392_5.

    Article  CAS  PubMed  Google Scholar 

  16. Abnet CC, Freedman ND, Hu N, Wang Z, Yu K, Shu XO, et al. A shared susceptibility locus in PLCE1 at 10q23 for gastric adenocarcinoma and esophageal squamous cell carcinoma. Nat Genet. 2010;42(9):764–7. https://doi.org/10.1038/ng.649.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Li WQ, Hu N, Wang Z, Yu K, Su H, Wang L, et al. Genetic variants in epidermal growth factor receptor pathway genes and risk of esophageal squamous cell carcinoma and gastric cancer in a Chinese population. PLoS One. 2013;8(7):e68999. https://doi.org/10.1371/journal.pone.0068999.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Stephens M, Smith NJ, Donnelly P. A new statistical method for haplotype reconstruction from population data. Am J Hum Genet. 2001;68(4):978–89. https://doi.org/10.1086/319501.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Wolpin BM, Kraft P, Gross M, Helzlsouer K, Bueno-de-Mesquita HB, Steplowski E, et al. Pancreatic cancer risk and ABO blood group alleles: results from the pancreatic cancer cohort consortium. Cancer Res. 2010;70(3):1015–23. https://doi.org/10.1158/0008-5472.CAN-09-2993.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Duell EJ, Bonet C, Munoz X, Lujan-Barroso L, Weiderpass E, Boutron-Ruault MC, et al. Variation at ABO histo-blood group and FUT loci and diffuse and intestinal gastric cancer risk in a European population. Int J Cancer. 2015;136(4):880–93. https://doi.org/10.1002/ijc.29034.

    Article  CAS  PubMed  Google Scholar 

  21. Mao Y, Yang W, Qi Q, Yu F, Wang T, Zhang H, et al. Blood groups A and AB are associated with increased gastric cancer risk: evidence from a large genetic study and systematic review. BMC Cancer. 2019;19(1):164. https://doi.org/10.1186/s12885-019-5355-4.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wang Z, Liu L, Ji J, Zhang J, Yan M, Zhang J, et al. ABO blood group system and gastric cancer: a case-control study and meta-analysis. Int J Mol Sci. 2012;13(10):13308–21. https://doi.org/10.3390/ijms131013308.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Tran GD, Sun XD, Abnet CC, Fan JH, Dawsey SM, Dong ZW, et al. Prospective study of risk factors for esophageal and gastric cancers in the Linxian general population trial cohort in China. Int J Cancer. 2005;113(3):456–63. https://doi.org/10.1002/ijc.20616.

    Article  CAS  PubMed  Google Scholar 

  24. Wang LD, Zhou FY, Li XM, Sun LD, Song X, Jin Y, et al. Genome-wide association study of esophageal squamous cell carcinoma in Chinese subjects identifies susceptibility loci at PLCE1 and C20orf54. Nat Genet. 2010;42(9):759–63. https://doi.org/10.1038/ng.648.

    Article  CAS  PubMed  Google Scholar 

  25. Kamangar F, Qiao YL, Blaser MJ, Sun XD, Katki H, Fan JH, et al. Helicobacter pylori and oesophageal and gastric cancers in a prospective study in China. Br J Cancer. 2007;96(1):172–6. https://doi.org/10.1038/sj.bjc.6603517.

    Article  CAS  PubMed  Google Scholar 

  26. Ren JS, Kamangar F, Qiao YL, Taylor PR, Liang H, Dawsey SM, et al. Serum pepsinogens and risk of gastric and oesophageal cancers in the general population nutrition intervention trial cohort. Gut. 2009;58(5):636–42. https://doi.org/10.1136/gut.2008.168641.

    Article  CAS  PubMed  Google Scholar 

  27. Abnet CC, Zheng W, Ye W, Kamangar F, Ji BT, Persson C, et al. Plasma pepsinogens, antibodies against helicobacter pylori, and risk of gastric cancer in the Shanghai women’s health study cohort. Br J Cancer. 2011;104(9):1511–6. https://doi.org/10.1038/bjc.2011.77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Wolpin BM, Kraft P, Xu M, Steplowski E, Olsson ML, Arslan AA, et al. Variant ABO blood group alleles, secretor status, and risk of pancreatic cancer: results from the pancreatic cancer cohort consortium. Cancer Epidemiol Biomark Prev. 2010;19(12):3140–9. https://doi.org/10.1158/1055-9965.EPI-10-0751.

    Article  CAS  Google Scholar 

  29. Linden S, Mahdavi J, Semino-Mora C, Olsen C, Carlstedt I, Boren T, et al. Role of ABO secretor status in mucosal innate immunity and H. pylori infection. PLoS Pathog. 2008;4(1):e2.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Yip SP, Lai SK, Wong ML. Systematic sequence analysis of the human fucosyltransferase 2 (FUT2) gene identifies novel sequence variations and alleles. Transfusion. 2007;47(8):1369–80. https://doi.org/10.1111/j.1537-2995.2007.01280.x.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank the study participants and staff of the Shanghai Men’s Health Study (SMHS), Shanghai Women’s Health Study (SWHS) and Singapore Chinese Health Study (SCHS). Supported by the National Cancer Institute (SMHS: R01 CA82729; SWHS: R37 CA70837 and contract NO2-CP-11010 with Vanderbilt University; SCHS: R01 CA55069, R35 CA53890, R01 CA80205 and R01 CA144034). The Shanxi Upper Gastrointestinal Cancer Genetics Project was supported by the National Cancer Institute contract NO2-SC-66211 with the Shanxi Cancer Hospital and Institute. The Nutrition Intervention Trials (NIT) were supported by National Cancer Institute contracts NO1-SC-91030 and HHSN261200477001C with the Cancer Institute of the Chinese Academy of Medical Sciences.

Funding

This study was supported by the NIH Intramural Research Program. The funding source had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. Open Access funding provided by the National Institutes of Health (NIH).

Author information

Authors and Affiliations

  1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr. 6E3280, Rockville, MD, 20850, USA

    Yingxi Chen, Nan Hu, Linda Liao, Kai Yu, Sanford M. Dawsey, Neal D. Freedman, Philip R. Taylor, Alisa M. Goldstein & Christian C. Abnet

  2. Department of Medicine, Division of Epidemiology, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA

    Xiao-Ou Shu & Wei Zheng

  3. UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA

    Jian-Min Yuan

  4. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Jian-Min Yuan

  5. Health Service and Systems Research, Duke-NUS Medical School, Singapore, 169857, Singapore

    Woon-Puay Koh

  6. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore

    Woon-Puay Koh

  7. National Cancer Center, National Center for Cancer Clinical Research, The Cancer Institute, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China

    You-Lin Qiao & Jin-Hu Fan

Authors
  1. Yingxi Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nan Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kai Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xiao-Ou Shu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wei Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jian-Min Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Woon-Puay Koh
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. You-Lin Qiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jin-Hu Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Sanford M. Dawsey
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Neal D. Freedman
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Philip R. Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Alisa M. Goldstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Christian C. Abnet
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study concept: YC, and CCA. Study design: PRT, and CCA. Acquisition of data: NH, XOS, JMY, YLQ, JHF, AMG, and CCA. Interpretation of data: YC, NH, LL, KY, XOS, WZ, JMY, WPK, YLQ, JHF, SMD, NDF, PRT, AMG, and CCA. Manuscript drafting: YC. Revising the manuscript: YC, NH, LL, KY, XOS, WZ, JMY, WPK, YLQ, JHF, SMD, NDF, PRT, AMG, and CCA. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yingxi Chen.

Ethics declarations

Ethics approval and consent to participate

The Shanxi UGI Cancer Genetics Project (registered at ClinicalTrials.gov as NCT00341276) was approved by Shanxi Cancer Hospital and Institute Institutional Review Board and the NCI Special Studies Institutional Review Board. The Linxian Nutrition Intervention Trials (registered at ClinicalTrials.gov as NCT00342654) was approved by Cancer Institute of the Chinese Academy of Medical Sciences Institutional Review Board and the NCI Special Studies Institutional Review Board. The Shanghai Women’s and Men’s Health Study were approved by the Institutional Review Boards of Vanderbilt University and the Shanghai Cancer Institute. The Singapore Chinese Health Study was approved by the institutional review boards at the National University of Singapore and the University of Minnesota. All subjects provided informed consent. The current study was a secondary analysis of de-identified data.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Chen, Y., Hu, N., Liao, L. et al. ABO genotypes and the risk of esophageal and gastric cancers. BMC Cancer 21, 589 (2021). https://doi.org/10.1186/s12885-021-08334-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12885-021-08334-1

Keywords

  • ABO blood type
  • Esophageal squamous cell carcinoma
  • Gastric cancer

BMC Cancer

ISSN: 1471-2407

Contact us