Helicobacter pylori and gastric cancer

• there is evidence of a causal association between H.pylori and cancer of the gastric corpus and antrum.
• the incidence of gastric cancer of the gastric corpus and gastric antrum are declining in areas where H.pylori infection is becoming less prevalent.
• patients treated with potent antisecretory drugs (e.g. proton pump inhibitors) who are infected with H.pylori develop a distribution of H.pylori infection within the stomach that is more usually associated with the development of mucosal atrophy, and found in the small minority of all H.pylori-infected patients who eventually develop cancer of the gastric antrum and corpus. This has led to the suggestion that it may be prudent to eradicate H.pylori in patients with severe gastro-oesophageal reflux who have proven need to long-term acid suppression
• prophylactic eradication of H pylori after endoscopic resection of early gastric cancer helps to prevent the development of metachronous gastric carcinoma (2)

Reference:

• 1. Drug and Therapeutic Bulletin (1998); 36 (8): 57-9.
• 2. Fukase K, Kato M, Kikuchi S, Inoue K, Uemura N, Okamoto S, Terao S, Amagai K, Hayashi S, Asaka M; Japan Gast Study Group.Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomised controlled trial. Lancet. 2008 Aug 2;372(9636):392-7.