Variable association of height with gastric cancer by anatomical subsite

To the Editor. Dr. Kabat and colleagues [1] presented an analysis of attained height with risk of cancer at different anatomic sites in a United States cohort, and reported no association in either sex for gastric cancer overall. It is well known that cancers of the gastric cardia and noncardia subsites have distinct etiologic factors. In particular, seropositivity for Helicobacter pylori is positively associated with noncardia gastric cancer but inversely associated with cardia cancer. For this reason, in our previous study of nearly the same cohort (restricted to Whites) [2], we evaluated associations of height tertiles with gastric cancer separately for each anatomic subsite. We found that noncardia gastric cancer was inversely associated with height, and interpreted the excess risk for shorter adults to be consistent with the known association of chronic H. pylori infection with growth retardation during childhood [3]. Nevertheless, it cannot be completely dismissed that H. pylori infection may be a surrogate marker for other factors associated with socioeconomic deprivation in early life. We did not find an association of height with cardia cancer.