A team from New Orleans, USA and Pasto, Colombia conducted a randomized intervention trial in subjects with pre-cancerous lesions of the stomach.
Subjects from the province of Nariño, Colombia, where the population has a high risk of gastric carcinoma, were assigned to receive anti-Helicobacter pylori triple therapy and/or dietary supplementation with ascorbic acid, beta-carotene, or their corresponding placebos.
All patients had confirmed histologic diagnoses of multifocal non-metaplastic atrophy and/or intestinal metaplasia.
Baseline gastric biopsy specimens were taken and were compared to specimens taken at 72 months.
The effects of treatments were estimated using multivariate polytomous logistic regression models.
The team found that all three basic interventions resulted in statistically significant increases in the rates of regression.
The relative risks were 4.8 for anti-H. pylori treatment, 5.1 for beta-carotene treatment, and 5.0 for ascorbic acid treatment, in subjects with atrophy. Corresponding relative risks of regression in subjects with intestinal metaplasia were 3.1, 3.4, and 3.3. Combinations of treatments did not statistically significantly increase the regression rates.
"Anti-H. pylori treatment and antioxidant micronutrients increase regression rates of cancer precursor lesions." Dr Pelayo Correa
Curing the H. pylori infection (which occurred in 74 per cent of the treated subjects) produced a marked and statistically significant increase in the rate of regression of the precursor lesions (relative risks = 8.7 for subjects with atrophy and 5.4 for subjects with intestinal metaplasia).
Dr Pelayo Correa said on behalf of the group, "In the very high-risk population studied, effective anti-H. pylori treatment and dietary supplementation with antioxidant micronutrients may interfere with the pre-cancerous process, mostly by increasing the rate of regression of cancer precursor lesions."
"This may be an effective strategy to prevent gastric carcinoma," he concluded.