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 26 May 2018

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News

Helicobacter pylori eradication to prevent gastric cancer

The incidence of gastric cancer development is similar between subjects receiving Helicobacter pylori eradication treatment and those receiving placebo, find physicians in the latest issue of the Journal of the American Medical Association.

News image

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Chronic Helicobacter pylori infection is associated with gastric cancer.

However, the effect of H. pylori eradication on the prevention of gastric cancer development in chronic carriers is unknown.

In this study, physicians from China determined whether the treatment of H. pylori infection reduced the incidence of gastric cancer.

The team performed a prospective, randomized, placebo-controlled, population-based primary prevention study. They included 1630 healthy carriers of H. pylori infection from Fujian Province, China. Participants were recruited in 1994 and followed up until 2002.

The team determined that 988 participants did not have precancerous lesions (gastric atrophy, intestinal metaplasia, or gastric dysplasia) on study entry.
Smoking and older age were independent risk factors for the development of gastric cancer.
Journal of the American Medical Association

Patients were randomized to receive H. pylori eradication treatment or placebo.

The team measured the incidence of gastric cancer during follow-up.

They also measured was incidence of gastric cancer in patients with or without precancerous lesions.

The physicians found that among the 18 new cases of gastric cancers that developed, no overall reduction was observed in those who received H. pylori eradication treatment.

However, in a subgroup of patients with no precancerous lesions on presentation, no patients who received eradication treatment developed gastric cancer during a follow-up. The team identified smoking (hazard ratio (HR) 6.2) and older age (HR 1.10) as independent risk factors for the development of gastric cancer in this cohort.

Dr Benjamin Chun-Yu Wong's team concluded, "The incidence of gastric cancer development at the population level was similar between participants receiving H. pylori eradication treatment and those receiving placebo during a period of 7.5 years in a high-risk region of China".

"In the subgroup of H. pylori carriers without precancerous lesions, eradication of H. pylori significantly decreased the development of gastric cancer".

"Further studies to investigate the role of H. pylori eradication in participants with precancerous lesions are warranted".

JAMA 2004; 291: 187-94
15 January 2004

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