Although no association between H. pylori positivity or stomach atrophy and ACE polymorphism was found in a Japanese study on 202 gastric cancer patients and 454 healthy controls, the risk of gastric cancer was significantly higher  among patients with I/D genotype affected by atrophic gastritis caused by Helicobacter pylori (OR = 1.59; 95%CI: 1.02–2.48) [89]. This evidence concerns the gene ACE and gastric cancer.