Eradication of H pylori for the prevention of gastric cancer

Abstract

Infection with H pylori is the most important known etiological factor associated with gastric cancer. While colonization of the gastric mucosa with H pylori results in active and chronic gastritis in virtually all individuals infected, the likelihood of developing gastric cancer depends on environmental, bacterial virulence and host specific factors. The majority of all gastric cancer cases are attributable to H pylori infection and therefore theoretically preventable. There is evidence from animal models that eradication of H pylori at an early time point can prevent gastric cancer development. However, randomized clinical trials exploring the prophylactic effect of H pylori eradication on the incidence of gastric cancer in humans remain sparse and have yielded conflicting results. Better markers for the identification of patients at risk for H pylori induced gastric malignancy are needed to allow the development of a more efficient public eradication strategy. Meanwhile, screening and treatment of H pylori in first-degree relatives of gastric cancer patients as well as certain high-risk populations might be beneficial.

Citrus Auraptene Reduces Helicobacter pylori Colonization of Glandular Stomach Lesions in Mongolian Gerbils

“…Recently, gastric carcinogenesis was associated with persistent chronic inflammation and the subsequent mucosal atrophy caused by Hp infection 26) . Based upon a large number of experimental and epidemiological studies, it is widely believed that the eradication of Hp should prevent gastric cancer [27][28][29] . The effect of many anti-inflammatory drugs on Hp-infected gastritis have been verified using animal models, with some of them exhibiting molecular and biologic advantages with possible chemopreventive effect against Hp-associated gastric carcinogenesis 30,31) .…”