title: Fifteen-year effects of Helicobacter pylori, garlic, and vitamin treatments on gastric cancer incidence and mortality.
abstract: In the Shandong Intervention Trial, 2 weeks of antibiotic treatment for Helicobacter pylori reduced the prevalence of precancerous gastric lesions, whereas 7.3 years of oral supplementation with garlic extract and oil (garlic treatment) or vitamin C, vitamin E, and selenium (vitamin treatment) did not. Here we report 14.7-year follow-up for gastric cancer incidence and cause-specific mortality among 3365 randomly assigned subjects in this masked factorial placebo-controlled trial. Conditional logistic regression was used to estimate the odds of gastric cancer incidence, and the Cox proportional hazards model was used to estimate the relative hazard of cause-specific mortality. All statistical tests were two-sided. Gastric cancer was diagnosed in 3.0% of subjects who received H pylori treatment and in 4.6% of those who received placebo (odds ratio = 0.61, 95% confidence interval = 0.38 to 0.96, P = .032). Gastric cancer deaths occurred among 1.5% of subjects assigned H pylori treatment and among 2.1% of those assigned placebo (hazard ratio [HR] of death = 0.67, 95% CI = 0.36 to 1.28). Garlic and vitamin treatments were associated with non-statistically significant reductions in gastric cancer incidence and mortality. Vitamin treatment was associated with statistically significantly fewer deaths from gastric or esophageal cancer, a secondary endpoint (HR = 0.51, 95% CI = 0.30 to 0.87; P = .014).
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University School of Oncology, Beijing Cancer Hospital and Beijing Institute for Cancer Research, Beijing, China.
authors.forename: Jun-Ling
authors.initials: JL
authors.lastname: Ma
authors.forename: Lian
authors.initials: L
authors.lastname: Zhang
authors.forename: Linda M
authors.initials: LM
authors.lastname: Brown
authors.forename: Ji-You
authors.initials: JY
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Shen
authors.forename: Kai-Feng
authors.initials: KF
authors.lastname: Pan
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Liu
authors.forename: Yuanreng
authors.initials: Y
authors.lastname: Hu
authors.forename: Zhong-Xiang
authors.initials: ZX
authors.lastname: Han
authors.forename: Susan
authors.initials: S
authors.lastname: Crystal-Mansour
authors.forename: David
authors.initials: D
authors.lastname: Pee
authors.forename: William J
authors.initials: WJ
authors.lastname: Blot
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Fraumeni
authors.forename: Wei-Cheng
authors.initials: WC
authors.lastname: You
authors.forename: Mitchell H
authors.initials: MH
authors.lastname: Gail
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000494:pharmacology; D002681:China / Q000453:epidemiology; D015986:Confounding Factors, Epidemiologic; D019587:Dietary Supplements; D005163:Factor Analysis, Statistical; D005260:Female; D005500:Follow-Up Studies; D005737:Garlic; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009853:Omeprazole / Q000627:therapeutic use*; D011230:Precancerous Conditions / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control*; D014810:Vitamin E / Q000494:pharmacology; D014815:Vitamins / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D005765:Gastrointestinal Agents; D014815:Vitamins; D014810:Vitamin E; D000658:Amoxicillin; D009853:Omeprazole; D001205:Ascorbic Acid