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001) and was independent of educational attainment. Among African Americans, there was no difference by sex; furthermore, sero-prevalence increased with increasing birth year among those with a high school education or less ( = 0.006). Among individuals in the United States born from the 1920s to 1960s, -CagA sero-prevalence has declined among Whites, but not among African Americans. Our findings suggest a widening racial disparity in the prevalence of the most virulent form of , the main cause of gastric cancer. Our findings suggest a

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