H. pylori eradication does not reduce gastric cancer incidence in a high-risk area of China

Bor-Shyang Sheu MD (Commentary Author), Xi-Zhang Lin MD (Commentary Author)
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引用次数: 2

Abstract

Question

Does treating H. Pylori reduce the incidence of gastric cancer?

Study

Randomised placebo-controlled trial.

Main results

At 7.5 years, incidence of gastric cancer was not significantly different between groups (treatment: 0.86%, n=7; placebo: 1.35%, n=11; p=0.33). In people without precancerous lesions at baseline, risk of gastric cancer was significantly lower for treatment compared with placebo (incidence of gastric cancer: treatment n=0; placebo n=6; p=0.02) but there was no difference among people with precancerous lesions (n=7 and 5, respectively). Smoking (hazard ratio [HR] 6.2, 95% CI 2.3 to 16.5) and older age (HR per 1 year 1.10, 95% CI 1.05 to 1.15) were independent predictors of gastric cancer risk.

Authors’ conclusions

Incidence of gastric cancer was similar between H. pylori eradication and placebo groups over 7.5 years of follow-up. However, it was significantly reduced in a subgroup of people without precancerous lesions at baseline.

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幽门螺杆菌根除并不能降低中国高风险地区胃癌的发病率
问题治疗幽门螺杆菌能降低癌症的发病率吗?研究随机安慰剂对照试验。主要结果7.5年时,各组癌症发生率无显著差异(治疗组:0.86%,n=7;安慰剂组:1.35%,n=11;p=0.33),与安慰剂相比,治疗癌症的风险显著降低(癌症的发病率:治疗n=0;安慰剂n=6;p=0.02),但癌前病变患者之间没有差异(分别为n=7和5)。吸烟(危险比[HR]6.2,95%CI 2.3-16.5)和年龄较大(每1年HR 1.10,95%CI 1.05-1.15)是癌症风险的独立预测因素。作者的结论在7.5年的随访中,根除幽门螺杆菌组和安慰剂组的癌症发病率相似。然而,在基线时没有癌前病变的亚组中,它显著降低。
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