Background: Helicobacter pylori (H. pylori) is the major determinant of environmental risk for gastric cancer. Although a link has been established between H. pylori and gastric cancer in animal models, results of clinical studies remain controversial. Methods: We conducted a nationwide cohort study based on data from 80,255 patients with H. pylori-infected peptic ulcer diseases over a 10-year period obtained from the Taiwan National Health Insurance Database (NHID). Patients were divided into early (H. pylori eradication within the first year of the index admission) and late eradication cohorts. Standardized incidence ratios (SIRs) and cumulative incidences were analyzed. Results: Early eradication cohort had significantly lower risk of development of gastric cancer (SIR=1.05, 95% CI: 0.96-1.14) than late eradication cohort (SIR=1.36, 95% CI: 1.24-1.49). In early eradication cohort, the SIR of gastric ulcer patients declined from 1.60 at 3 to 4 years to 1.05 at 7 to 10 years after index hospitalization. Over the same periods, the SIR of duodenal ulcer patients declined from 0.57 to 0.33. In late eradication cohort, similar trends were observed. The SIRs decreased from 2.14 to 1.32 for patients with gastric ulcer and from 0.90 to 0.66 for patients with duodenal ulcer. Early H. pylori eradication was also associated with lower risk of gastric cancer in patients regularly receiving aspirin or NSAIDs, as well as in patients who are not. Conclusions: H. pylori eradication therapy should be carried out as soon as possible in patients with peptic ulcer diseases to prevent gastric cancer development.
Date:
2009-05
Relation:
Cancer Research. 2009 May;69:Abstract number 2156.
