Take S et al. (2005) The effect of eradicating Helicobacter pylori on the development of gastric cancer in patients with peptic ulcer disease. Am J Gastroenterol 100: 1037–1042Individuals infected with the bacterium Helicobacter pylori are at increased risk of developing gastric cancers. Take and colleagues investigated whether H. pylori eradication therapy can prevent the development of gastric cancer in patients with peptic ulcer disease.This study recruited 1,342 predominantly male (n = 1,191) factory workers with gastric ulcers (n = 776), duodenal ulcers (n = 495), or both (n = 71) who had undergone one of three H. pylori eradication therapy regimens: a 2-week course of amoxicillin and a proton-pump inhibitor (PPI; omeprazole or lansoprazole) (n = 619); or 1-week courses of amoxicillin, clarithromycin, and a PPI (omeprazole, lansoprazole, or rabeprazole) (n = 670); or metronidazole, amoxicillin or clarithromycin, and a PPI (omeprazole, lansoprazole, or rabeprazole) (n = 53). H. pylori status was then evaluated with a 13C-urea breath test and endoscopy.Of those enrolled in the study, 1,120 were followed up for at least 1 year (mean follow-up 3.4 years) and for a maximum of 8.6 years. Gastric cancer developed in 4 (2.3%) of the 176 patients for whom eradication therapy had been unsuccessful, and 8 (0.8%) of the 944 patients in whom H. pylori had been eradicated (P = 0.04). None of the patients who had only duodenal ulcers developed gastric cancer. Hazard-ratio analysis revealed that persistent H. pylori infection was a significant risk factor for gastric cancer in patients with gastric ulcers (P = 0.04). The authors advocate future large-scale studies to investigate the outcome of H. pylori eradication on the incidence of gastric cancer.
https://www.nature.com/articles/ncponc0240-nrclinonc
Helicobacter pylori infection and gastric cancer: is there a role for eradication therapy?
