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Removing H. pylori bacteria cuts risk of stomach cancer
Source: (cancerfacts.com)
Monday, August 04, 2008
LONDON – Aug. 4, 2008 – Removing the bacteria long known to cause stomach ulcers in stomach cancer patients may slash the risk of the cancer coming back, say Japanese researchers.
Almost all stomach cancers not related to the heart develop from H. pylori a bacteria that infects the lining of the stomach. As such the World Health Organization has classified the bacteria as a group I carcinogen for stomach cancer. And while removal of H. pylori has a protective effect on stomach cancer in animal models, results of trials in human beings have produced conflicting results.
Led by Dr. Mototsugu Kato and Dr Masahiro Asaka, Hokkaido University Graduate School of Medicine, Japan, researchers from the Japan Gast Study Group did a randomised controlled trial of 544 patients to investigate the possible preventative effect of H. pylori eradication on the development of stomach cancer after surgery to remove early gastric cancer. The study appears an article published in this week's edition of The Lancet.
"The results of our study suggest that treatment to eradicate H. pylori reduces the risk of developing new gastric carcinoma in patients who have a history of such disease and are thus at risk for developing further gastric cancers," the researchers wrote. "We believe that our data add to those from previous studies showing a causal relationship between H. pylori infection and gastric cancer, and also support the use of H. pylori eradication to prevent the development of gastric cancer."
Patients with early stomach cancer were randomly assigned to receive either an H. pylori eradication regimen (272 patients) or no treatment (272) after surgery to remove the tumor. The eradication group received a combination drug treatment using lansoprazole, amoxicillin, and clarithromycin twice daily for a week. The comparison group received standard care but no additional treatment to remove H. pylori. Patients were then examined with an endoscope at 6, 12, 24 and 36 months to see if a new cancer had developed at a different site in the stomach.
After 3 years gastric cancer had developed at a different site than the original tumor in 9 patients in the eradication group compared to 24 in the control group. Overall, the risk of developing such cancer was reduced by around two thirds in the eradication group compared with the control group.
In an accompanying editorial, Dr Nicholas Talley, of the Mayo Clinic Jacksonville, Florida, says the result show that stomach cancer screening might be more beneficial than colonoscopy in high-risk regions of the world.
"Colonoscopy is used to screen for colorectal cancer in many countries, although direct evidence from published randomised trials of benefits versus risks are not available," Talley said. "Yet, worldwide, gastric cancer kills more people, and there is better evidence that H. pylori eradication can prevent mortality than there is for colonoscopy screening. Preventing gastric cancer by eradicating H. pylori in high-risk regions should be a priority."
SOURCE: press materials provided by The Lancet
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