The effect of Helicobacter pylori eradication on reducing the incidence of gastric cancer.
Epidemiologically, the association between chronic Helicobacter pylori infection and development of gastric cancer is well established. Although the possibility of preventing gastric cancer by eradicating H. pylori infection was recently investigated by several research groups, the results remain controversial. The aim of this study was to determine whether the eradication of H. pylori infection would reduce the incidence of gastric cancer. In total, 304 patients with persistent H. pylori infection and 404 patients with H. pylori infection eradicated were examined annually for gastric cancer by endoscopy. Over an average of 3.1 years for the first group and 3.2 years for the second group, 13 and 6 patients, respectively, were diagnosed as having new gastric cancer. The cumulative incidence of gastric cancer was statistically different between the groups (P=0.019; log-rank test). The hazard ratio of H. pylori eradication was 0.335 by Cox proportional hazards model (P=0.047). Differentiated gastric cancer was found in 11 patients in the persistent infection group and 3 patients in the eradicated group. The incidence of differentiated cancer was significantly different (P=0.017) between the groups, but not for undifferentiated cancer (P=0.847). The results of the current study suggest that the eradication of H. pylori infection reduces the incidence of gastric cancer.
Ogura
Keiji
K
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan. keiji-tky@umin.ac.jp
Hirata
Yoshihiro
Y
Yanai
Ayako
A
Shibata
Wataru
W
Ohmae
Tomoya
T
Mitsuno
Yuzo
Y
Maeda
Shin
S
Watabe
Hirotsugu
H
Yamaji
Yutaka
Y
Okamoto
Makoto
M
Yoshida
Haruhiko
H
Kawabe
Takao
T
Omata
Masao
M
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000907:Antibodies, Bacterial / Q000032:analysis; D001706:Biopsy; D004359:Drug Therapy, Combination; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D064747:Lansoprazole; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies; D013270:Stomach / Q000382:microbiology / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents; D000907:Antibodies, Bacterial; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D008795:Metronidazole; D000658:Amoxicillin