The Relationship Between Rh and ABO Blood Groups Distribution and the Incidence of Gastric Cancer and Peptic Ulcer Disease: Case-Control Study

Background: In 1953, Aird et al. found an association between blood group A and gastric cancer, and between blood group O and peptic ulcer disease (PUD). Further research demonstrated relationships between ABO blood groups and some diseases. No studies included Rh blood groups in the analysis. In addition, a controversy exists among studies investigating the association of ABO blood groups with gastric cancer and PUD.

Aim: This study aims to investigate the relationship between Rh and ABO blood groups and the incidence of gastric cancer and PUD. To our knowledge, this is the first study that includes Rh blood groups in the investigation.

Methods: It is acase-control study. It involved all patients who undergone esophagogastroduodenoscopy (EGD) in Aleppo University Hospital during the study period. We did Rh and ABO blood group typing for all participants. We took biopsies from all ulcers, tumors and infiltrative lesions, and the biopsies were histologically examined. We formed four case groups: benign PUD group (n=276), benign gastric ulcer group (n=125), benign duodenal ulcer group (n=169), and gastric cancer group (n=26). the control group (n=276) consisted of participants whose EGDs were normal or revealed only gastritis or duodenitis. We used ODDs Ratio with 95% confidence interval and P-value to evaluate statistical significance of differences between groups.

Results: We found no significant relationship between Rh blood groups and gastric cancer or PUD. We found no relationship between ABO blood groups and PUD. We detected an increased risk of gastric cancer among blood group A(OR=1.24, 95% CI 1.11-1.46, P=0.02). Non-A groups revealed no significant risk. 100% of biopsies showed H.pyloriinfection.

Conclusion: After comparing our findings to available literature, we suggest larger-scale studies to investigate the association of non-A groups with gastric cancer, and Rh groups with gastric cancer and PUD . We recommend studying the feasibility of establishing screening programs for gastric cancer in people with blood group A, and consideringblood group A as a risk factor that may indicate EGD in the presence of upper gastrointestinal symptoms. We should determine the prevalence of H.pylori infection in the Syrian population.

Keywords: Rh, ABO, Peptic Ulcer Disease, Gastric Cancer.