- Treatment of Helicobacter pylori infection leads to fewer cases of gastric cancer among participants with a first-degree relative diagnosed with gastric cancer.
Why this matters
- Due to a lack of evidence, there is disagreement among guidelines and consensus reports as to whether test and treat H pylori among individuals with a first-degree relative history of gastric cancer.
- 1838 individuals with a first-degree relative diagnosed with gastric cancer and who had H pylori infections were randomized to H pylori eradication (lansoprazole, amoxicillin, and clarithromycin) or placebo.
- Funding: National Cancer Center, South Korea.
- Median follow-up, 9.2 years.
- 1.2% of the treatment group developed gastric cancer, compared with 2.7% of placebo (HR, 0.45; P=.03).
- Intention-to-treat analysis showed treatment led to fewer cases of gastric cancer: HR, 0.42 (95% CI, 0.20-0.89).
- Number needed to treat to prevent one gastric cancer, 65.7 (95% CI, 35.1-503.8).
- Gastric cancer incidence was lower in participants with eradicated infection (0.94 vs 3.41 cases per 1000 person-years).
- There was no significant difference in OS between the 2 groups, and no deaths from gastric cancer in either group.
- Single-center study.