September 17, 2019
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H. pylori treatment, vitamins, garlic reduce gastric cancer mortality

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Over the course of 22 years of follow-up, treatment for Helicobacter pylori infection, as well as vitamin and garlic supplementation, reduced the risk for death due to gastric cancer.

Kai-Feng Pan, MD, PhD, of the department of cancer epidemiology at Peking University Cancer Hospital and Institute, and colleagues wrote that previous research has shown the benefit of all three treatments, but little is known about their long-term impact.

“Solid evidence from epidemiologic studies links infection with Helicobacter pylori to the progression of precancerous gastric lesions and development of gastric cancer and shows that diets rich in vitamins and garlic could protect against gastric cancer in high risk people with insufficient vitamin intake,” they wrote.

Researchers conducted a blinded, placebo-controlled trial comprising 3,365 individuals who live in a region that has high risk for gastric cancer. Of those individuals, 2,258 were seropositive for antibodies to H. pylori, and 1,107 were seronegative. Investigators randomly assigned individuals in each group to undergo either H. pylori treatment (amoxicillin and omeprazole) for 2 weeks, vitamin supplementation (vitamins C, E and selenium) for 7 years, garlic supplementation (extract and oil) for 7 years or their placebos.

Cumulative incidence of gastric cancer and deaths due to gastric cancer served as the primary outcomes.

Between 1995 and 2017, researchers identified 151 incident cases of gastric cancer and 94 deaths from gastric cancer. They determined that H. pylori treatment had a protective effect against gastric cancer incidence that persisted for 22 years after intervention (OR = 0.48; 95% CI, 0.32–0.71). Incidence also decreased among patients who received vitamin supplementation (OR = 0.64; 95% CI, 0.46–0.91) but not garlic supplementation.

However, all three interventions produced reductions in gastric cancer mortality; H. pylori treatment (HR = 0.62; 95% CI, 0.39–0.99), vitamin supplementation (HR = 0.48; 95% CI, 0.31–0.75) and garlic supplementation (HR = 0.66; 95% CI, 0.43–1).

“These findings suggest many potential strategies for gastric cancer prevention,” Pan and colleagues wrote. “However, before major public health campaigns for gastric cancer prevention are launched utilizing antibiotic based H. pylori treatment or nutritional regimens, further large scale intervention trials are warranted to delineate the full range of beneficial and adverse effects of H. pylori treatment, to confirm the preventive effects of vitamin and garlic supplementation, and to identify possible risks from nutritional regimens.” by Alex Young

Disclosures: The authors report no relevant financial disclosures.