Treatment for H. Pylori Reduces Gastric Cancer Risk, Even in Those With Family History

Patients with Helicobacter pylori (H. pylori) infection and a first-degree family history of gastric cancer had a reduced risk of developing gastric cancer if they received H. pylori treatment, according to a study published in The New England Journal of Medicine. H. pylori infection is a primary risk factor for gastric cancer, as is family history.

The single-center, double-blind, placebo-controlled trial randomized 1,676 patients with H. pylori infection to receive either eradication therapy, consisting of lansoprazole 30 mg, amoxicillin 1,000 mg, and clarithromycin 500 mg each taken twice daily for seven days (n=832); or placebo (n=844).

Less cancer cases in the treatment group

After a median follow-up of 9.2 years, 10 patients (1.2%) in the treatment group developed gastric cancer, while 23 (2.7%) in the placebo group developed gastric cancer (hazard ratio [HR], 0.45; 95% CI, 0.21-0.94; P=0.03).

Among the 10 patients in the treatment group who developed cancer, five (50%) had persistent H. pylori infection. Overall, gastric cancer developed in 0.8% of patients (n=5/608) in whom H. pylori infection was eradicated and in 2.9% of patients (n=28/979) who had persistent infection (HR, 0.27; 95% CI, 0.10-0.70).

A total of 16 patients in the treatment group and 18 in the placebo group died. There were no significant between-group difference is overall survival rates.

Adverse events were mild but occurred more commonly in patients in the treatment group (53.0% vs. 19.1%; P<0.001), the most common of which were taste alteration, nausea, diarrhea, and abdominal pain.