Background and Aims
The effect of Helicobacter pylori eradication on de novo gastric cancer is controversial, although meta-analyses suggest
a reduction in gastric cancer after eradication. The effect of high-density lipoprotein
(HDL) on gastric cancer has been rarely reported.
Methods
In this large retrospective cohort study, participants underwent endoscopy and H pylori testing from 2003 to 2011 and underwent follow-up endoscopy and H pylori testing until 2013. H pylori infection was detected using a rapid urease test or histologic test. The H pylori eradication group was defined as successful eradication, whereas the H pylori persistent group was defined as noneradication or eradication failure. The risk of
cancer was measured with hazard ratios (HRs) and 95% confidence intervals (CIs).
Results
Among 10,328 healthy subjects (5951 men; mean age, 48.7 years), 31 gastric cancers
were detected during a median follow-up of 5.5 years. De novo gastric cancer developed
in 21 of 3508 subjects (.6%) in the noneradication group, 4 of 2050 subjects (.2%)
in the successful eradication group, and 6 of 4770 participants (.13%) in the absence
of H pylori group. In the adjusted analysis, H pylori eradication decreased de novo gastric cancer risk (HR, .29; 95% CI, .10-.86) compared
with the persistent group. The risk of de novo gastric cancer in absence of H pylori was also much lower compared with the persistent group (HR, .24; 95% CI, .09-.60).
Low serum HDL increased the risk of de novo gastric cancer (HR, 2.67; 95% CI, 1.14-6.16).
Conclusions
Successful H pylori eradication reduced de novo gastric cancer, whereas low HDL increased its risk.
Graphical abstract
Graphical Abstract
Abbreviations:
AGC (advanced gastric cancer), BMI (body mass index), CI (confidence interval), EGC (early gastric cancer), HDL (high-density lipoprotein), HR (hazard ratio), LDL (low-density lipoprotein), RCT (randomized controlled trial)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 26, 2019
Accepted:
April 16,
2019
Received:
February 2,
2019
Footnotes
DISCLOSURE: This study was supported by grant number NCC 1410530 (S.Y. Nam) from the National Cancer Center, Korea. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Center. The funding source partially supports review of clinical data. The funding source did not play any role in planning and implementing this study, in interpreting its results, and in writing this paper. All authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Nam at [email protected]
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- Gastric cancer risk stratification and surveillance after Helicobacter pylori eradication: 2020Gastrointestinal EndoscopyVol. 90Issue 3
- PreviewGastric cancer remains one of the most common causes of cancer deaths worldwide. The best current option for reducing gastric cancer deaths is Helicobacter pylori eradication combined with risk assessment and surveillance programs for those deemed to be at high risk for gastric cancer so as to identify lesions at a stage amenable to curative therapy. In this issue, Nam et al1 report a retrospective study of Helicobacter pylori eradication on gastric cancer incidence among 10,328 Korean adults undergoing health checkups including an H pylori test-and-treat program.
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