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J Natl Cancer Inst. 2014 Jun 12;106(7). pii: dju116. doi: 10.1093/jnci/dju116. Print 2014 Jul.

Effects of Helicobacter pylori treatment on gastric cancer incidence and mortality in subgroups.

Author information

1
Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (W-QL, JFF, MHG); Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital and Institute, Beijing, China (W-QL, J-LM, LZ, J-YL, LS, K-FP, W-CY); RTI International, Rockville, MD (LMB); Linqu County Public Health Bureau, Shandong, China (W-DL, Z-XH); Westat, Rockville, MD (SC-M); Information Management Services, Rockville, MD (DP); International Epidemiology Institute, Rockville, MD (WJB); Department of Medicine (Epidemiology), Vanderbilt University, Nashville, TN (WJB).
2
Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (W-QL, JFF, MHG); Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Cancer Epidemiology, Peking University Cancer Hospital and Institute, Beijing, China (W-QL, J-LM, LZ, J-YL, LS, K-FP, W-CY); RTI International, Rockville, MD (LMB); Linqu County Public Health Bureau, Shandong, China (W-DL, Z-XH); Westat, Rockville, MD (SC-M); Information Management Services, Rockville, MD (DP); International Epidemiology Institute, Rockville, MD (WJB); Department of Medicine (Epidemiology), Vanderbilt University, Nashville, TN (WJB). gailm@mail.nih.gov weichengyou@yahoo.com.

Abstract

Among 2258 Helicobacter pylori-seropositive subjects randomly assigned to receive one-time H. pylori treatment with amoxicillin-omeprazole or its placebo, we evaluated the 15-year effect of treatment on gastric cancer incidence and mortality in subgroups defined by age, baseline gastric histopathology, and post-treatment infection status. We used conditional logistic and Cox regressions for covariable adjustments in incidence and mortality analyses, respectively. Treatment was associated with a statistically significant decrease in gastric cancer incidence (odds ratio = 0.36; 95% confidence interval [CI] = 0.17 to 0.79) and mortality (hazard ratio = 0.26; 95% CI = 0.09 to 0.79) at ages 55 years and older and a statistically significant decrease in incidence among those with intestinal metaplasia or dysplasia at baseline (odds ratio = 0.56; 95% CI = 0.34 to 0.91). Treatment benefits for incidence and mortality among those with and without post-treatment infection were similar. Thus H. pylori treatment can benefit older members and those with advanced baseline histopathology, and benefits are present even with post-treatment infection, suggesting treatment can benefit an entire population, not just the young or those with mild histopathology.

PMID:
24925350
PMCID:
PMC4067110
DOI:
10.1093/jnci/dju116
[Indexed for MEDLINE]
Free PMC Article

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