This article is more than 5 years old. Information may no longer be current.
H. pylori eradication linked to reduced gastric cancer incidence
Click Here to Manage Email Alerts
Eradication of Helicobacter pylori infection was associated with a reduced incidence of gastric cancer in populations with different levels of gastric cancer risk, according to the results of a systematic review and meta-analysis.
“There has been increasing interest in mass H. pylori eradication to prevent gastric cancer. However, the benefit of eradication varies in relation to baseline gastric cancer risk, which varies widely across regions and populations, and the extent to which mass H. pylori eradication will affect gastric cancer incidence remains unclear,” David Y. Graham, MD, from the department of medicine, Michael E. DeBarkey VA Medical Center, Baylor College of Medicine in Houston, Texas, and colleagues wrote. “A better understanding of the size of the benefit to be expected after eradicating H. pylori in populations with differing levels of gastric cancer risk is crucial in deciding whether and how mass eradication of H. pylori should be implemented.”
To determine the association between H. pylori eradication and gastric cancer incidence, the researchers performed a systematic review and meta-analysis of randomized controlled trials and cohort studies published through May 2015, which evaluated both asymptomatic H. pylori carriers and patients undergoing endoscopic resection of early gastric cancer.
The meta-analysis included 24 mostly Asian studies, representing 715 incident gastric cancers among 48,064 individuals with 340,255 person-years of follow-up.
After adjusting for baseline gastric cancer incidence, individuals who underwent H. pylori eradication had a lower incidence of gastric cancer compared with those who did not undergo eradication therapy (pooled incidence rate ratio = 0.53; 95% CI, 0.44-0.64), with little heterogeneity between studies.
There appeared to be a greater but nonsignificant benefit of eradication therapy among individuals who underwent endoscopic resection of gastric cancers (pooled IRR = 0.46; 95% CI, 0.35-0.6) compared with asymptomatic infected individuals (pooled IRR = 0.62; 95% CI, 0.49-0.79). The benefits of eradication were comparable between study designs, sex and follow-up periods.
Baseline gastric cancer incidence, which varied widely between studies (34.3-10,256.4 per 100,000 person-years), significantly modified the benefit of H. pylori eradication (P = .037 for interaction). There was a nonlinear reduction in the IRR of gastric cancer with increasing baseline incidence of gastric cancer (P = .018 vs. the linear model). Age also seemed to modestly modify the benefit (P = .023 for interaction), but this “might be due to the fact that studies with older patients tended to have higher baseline gastric cancer incidence,” the researchers wrote.
They concluded that this study “confirms that H. pylori eradication is associated with a reduction of the incidence of gastric cancer. Although the level of benefit varies, it presents across all levels of baseline gastric cancer risk. H. pylori eradication may be the most viable strategy for gastric cancer prevention.” – by Adam Leitenberger
Disclosures : Graham reports he is a consultant for RedHill Biopharma regarding novel H. pylori therapies and has received research support for culture of H. pylori; is a consultant for Otsuka Pharmaceuticals regarding diagnostic breath testing and for BioGaia in relation to probiotic therapy for H. pylori infection.
Click Here to Manage Email Alerts