H pylori Eradication Assessed for Prevention of Gastric Cancer

Patients positive for Helicobacter pylori (H pylori) who received treatment to eradicate the bacterium had significantly reduced incidence of noncardia gastric adenocarcinoma (NCGA) over 8 years in comparison to patients who had not been treated, according to research published online in the journal Gastroenterology.

“The risk among treated individuals became lower than the general population after 7 to 10 years of follow-up,” wrote the investigators from Kaiser Permanente Northern California and the University of California San Diego.

“We performed a retrospective cohort study of Kaiser Permanente Northern California members who underwent testing and/or treatment for H pylori between 1997 and 2015 and were followed through December 31, 2018.” The team evaluated the risk of NCGA using the Fine-Gray subdistribution hazard model and standardized incidence ratios.

“Among 716,567 individuals with a history of H pylori testing and/or treatment, the adjusted subdistribution hazard ratios and 95% confidence intervals of NCGA for H pylori–positive/untreated and H pylori–positive/treated individuals were 6.07 (4.20–8.76) and 2.68 (1.86–3.86), respectively, compared with H pylori–negative individuals,” the researchers reported. “When compared directly with H pylori–positive/untreated individuals, subdistribution hazard ratios for NCGA in H pylori–positive/treated were 0.95 (0.47–1.92) at <8 years and 0.37 (0.14–0.97) ≥8 years of follow-up.”

Standardized incidence ratios (95% confidence interval) of NCGA showed a steady decrease after H pylori treatment compared with the general population of  Kaiser Permanente Northern California patients, the authors noted, ranging from 2.00 at 1 year to 1.01 to 0.51 ≥10 years.

“In a large, diverse, community-based population, H pylori eradication therapy was associated with a significantly reduced incidence of NCGA after 8 years compared with no treatment,” the authors wrote. “The findings support the potential for substantial gastric cancer prevention in the United States through H pylori eradication.”

Reference:

Li D, Jiang SF, Lei NY, Shah SC, Corley DA. Effect of Helicobacter pylori eradication therapy on the incidence of noncardia gastric adenocarcinoma in a large diverse population in the United States. Gastroenterology. Published online May 2, 2023.

DOI: https://doi.org/10.1053/j.gastro.2023.04.026