H Pylori Eradication Reduces Gastric Cancer Risk

Eradication of Helicobacter pylori reduced the incidence of gastric cancer in patients from a high-risk area in southern China over 26.5 years of follow-up, according to a study published in the journal Gastroenterology.

“These findings call for actions to eradicate H pylori among high-risk populations,” researchers wrote, “and further underscores the importance of prompt retreatment for those who fail eradication or protection against reinfection.”

The study included 1630 patients with asymptomatic, H pylori infection in Changle of Fuzhou, a high-risk area for gastric cancer in southern China in July 1994. Some 817 patients were randomly assigned to standard triple therapy for H pylori eradication and 813 patients to placebo.

Follow-up through December 2020 revealed gastric cancer diagnoses in 2.57% of patients in the treatment group compared with 4.31% of patients in the placebo group. The hazard ratio of gastric cancer with H pylori treatment was 0.57, the study showed.

Patients without premalignant gastric lesions and without dyspepsia symptoms at baseline showed the most benefit from H pylori treatment. Successful eradication and no reinfection during follow-up were also key.

“Compared with 32 cases of gastric cancer observed among 527 participants with persistent H pylori infection in the placebo group, only 16 were identified in 625 subjects with successful eradication in the treatment group,” researchers wrote.

However, analysis identified no significant differences between the 2 groups for all-cause mortality or other cause-specific mortalities.

“In conclusion, our study provides strong evidence that H pylori eradication therapy significantly reduces the risk of developing gastric cancer, which might be confined to the subgroup without precancerous gastric lesions at baseline,” researchers wrote. “These findings highlight the need for prompt treatment for carriers of H pylori infection in high-risk populations, especially among those without advanced gastric lesions.”

—Jolynn Tumolo

Reference:
Yan L, Chen Y, Chen F, et al. Effect of Helicobacter pylori eradication on gastric cancer prevention: updated report from a randomized controlled trial with 26.5 years of follow-up. Gastroenterology. 2022;163(1):154-162.e3.