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The aetiology of cardia cancer and the role of Helicobacter pylori in its pathogenesis remain unclear. The junctional position of this cancer is a source of misclassification; some cases may be oesophageal adenocarcinomas while others may be gastric adenocarcinomas. If the aetiology of this cancer is to be understood, we need a way of separating the two entities. Hansen et al addressed this question by comparing the premorbid state of the stomach in cardia vs non-cardia cancers. They used a nested case–control design that included 129 non-cardia cancers and 44 cardia cancers in Norway (each case had three matched controls). Serum collected a median of 11.9 years before the diagnosis of cancer was tested for anti-H pylori antibodies, pepsinogen I:II and gastrin. Cardia cancer was negatively associated with H pylori (OR 0.27, 95% CI 0.12 to 0.59), but H pylori-positive cardia cancer showed a positive association with gastric
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