Gastric cancers in Finnish patients after cure of Helicobacter pylori infection: A cohort study
Open Access
- 23 November 2010
- journal article
- research article
- Published by Wiley in International Journal of Cancer
- Vol. 128 (2), 433-439
- https://doi.org/10.1002/ijc.25337
Abstract
Helicobacter pylori infection is associated with gastric cancer. A total of 97% of the infected subjects have elevated levels of H. pylori antibodies. The antibody titers have been shown to decline rapidly (40–60% within 4–12 months) only after successful eradication therapy. We allocated 26,700 consecutive patients tested during 1986–1998 for H. pylori antibodies to 3 subcohorts: seropositive patients with rapidly falling antibody titers (Hp+CURED, n = 3,650), seropositive patients where no serological information indicating cure was obtained (Hp+NoInfo, n = 11,638) and seronegative patients (Hp–, n = 11,422). In the subcohorts, the standardised incidence ratios (SIRs) with 95% confidence intervals (CI) were defined for subsequent cancers of stomach, pancreas, colon, rectum, breast and prostate separately and for all cancers except stomach combined. The mean follow-up time was 10.1 years and the number of gastric cancers was 72. For the Hp+CURED, the SIR for gastric cancers for the first 5 follow-up years was 1.62 but decreased from the sixth follow-up year thereon to 0.14 (CI: 0.00–0.75). Likewise, the risk ratio, defined in a Poisson regression analysis using the Hp+NoInfo group as the reference, decreased from 1.60 to 0.13 (CI: 0.02–1.00, p = 0.049). The SIR for Hp– was not significantly higher than that for Hp+NoInfo for any of the cancers analysed. To conclude, cured H. pylori infection led to a significantly decreased incidence of gastric cancers from the sixth follow-up year. Advanced atrophic gastritis would be a plausible contributor to the elevated SIR in elderly Hp– patients.Keywords
This publication has 38 references indexed in Scilit:
- Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trialThe Lancet, 2008
- The Effect of Helicobacter pylori Eradication on Reducing the Incidence of Gastric CancerJournal of Clinical Gastroenterology, 2008
- Two distinct aetiologies of cardia cancer; evidence from premorbid serological markers of gastric atrophy and Helicobacter pylori statusGut, 2007
- Helicobacter pylori eradication reduced the incidence of gastric cancer, especially of the intestinal typeAlimentary Pharmacology & Therapeutics, 2007
- Systematic review: Helicobacter pylori eradication for the prevention of gastric cancerAlimentary Pharmacology & Therapeutics, 2006
- Randomized Double-Blind Factorial Trial of Three Treatments To Reduce the Prevalence of Precancerous Gastric LesionsJNCI Journal of the National Cancer Institute, 2006
- Long term follow up of patients treated for Helicobacter pylori infectionGut, 2005
- Accuracy of IgG Serology and Other Tests in ConfirmingHelicobacter pyloriEradicationScandinavian Journal of Gastroenterology, 1998
- Data Quality and Quality Control of a Population-Based Cancer Registry: Experience in FinlandActa Oncologica, 1994
- Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pyloriThe Lancet, 1993