Chemoprevention of gastric cancer: current status.
The development of gastric cancer is a multi-factor process. In addition to genetic factors, environmental factors including smoking, low gastric acidity, excessive intake of salt or salty food and low consumption of fresh fruits and vegetables all contribute to the development of gastric cancer. Of particular interest, epidemiological and experimental studies have demonstrated that Helicobacter pylori (H. pylori) infection is causally linked to gastric cancer. Most studies using micronutrient supplementation have failed to demonstrate any preventive effect against the development of gastric cancer. The use of non-steroidal anti-inflammatory drugs has been consistently observed to protect against the development of gastric cancer. Recently, eradication of H. pylori infection by a chemopreventative approach is being studied in a number of trials. Studies using precancerous lesions as an end point of the treatment have produced conflicting and mostly negative results. Trials using cancer as an end point are being cautiously carried out in high-risk populations, and will provide the definitive answer to this important question. In the end, vaccination may be proven to be the optimal strategy in human for the management of H. pylori infection and prevention of gastric cancer.
Xia
Harry Hua-Xiang
HH
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.
Wong
Benjiamin Chun-Yu
BC
Lam
Shiu-Kum
SK
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D019587:Dietary Supplements; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D013274:Stomach Neoplasms / Q000209:etiology / Q000517:prevention & control*; D014611:Vaccination
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016588:Anticarcinogenic Agents