- Eradication treatment for Helicobacter pylori infection cuts gastric cancer risk by 55% among first-degree relatives of patients with gastric cancer.
- Authors emphasize importance of confirming eradication.
Why this matters
- Having a first-degree relative with gastric cancer can multiply personal risk.
- Because of lack of evidence, 2017 American College of Gastroenterology guidelines did not include a recommendation about routine H pylori testing and treatment for this group, though other guidelines recommend doing so.
- Median follow-up: 9.2 years.
- Eradication vs placebo group:
- Gastric cancer onset: 1.2% (10/832) vs 2.7% (23/844; P=.03).
- Of 10 in the eradication group who developed cancer, 5 had persistent infection.
- HR, 0.45 (95% CI, 0.21-0.94).
- Adverse events: 53.0% vs 19.1% (P<.001 no deaths>
- Gastric cancer onset in participants from either group with eradicated vs persistent infection: 0.8% (5/608) vs 2.9% (28/979).
- HR, 0.27 (95% CI, 0.10-0.70).
- Single-center, double-blind, placebo-controlled trial of people ages 40-65 years who were positive for H pylori infection and whose first-degree relative had cancer (n=1838).
- Researchers randomly assigned participants to eradication therapy vs placebo.
- All underwent endoscopic surveillance every 2 years.
- Outcome: gastric cancer.
- Funding: National Cancer Center, South Korea.
- No analysis of patient genetics, bacterial risk factors.