Effect on <i>Helicobacter pylori</i> eradication therapy against gastric cancer in Japan

Tsuda, Momoko; Asaka, Masahiro; Kato, Mototsugu; Matsushima, Rumiko; Fujimori, Kenji; Akino, Kozo; Kikuchi, Shogo; Lin, Yingsong; Sakamoto, Naoya

doi:10.1111/hel.12415

Cited by 102 publications

(99 citation statements)

References 16 publications

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“…Although our results emphasize the adverse effect of eradication therapy, there is no doubt that eradication therapy provides many benefits, including the primary prevention of gastric cancer and decreased mortality due to gastric cancer [6]. In the present study, it is important to note that the degree of submucosal invasion was less than 1 mm and no patient had recurrence at the time of confirmation.…”

Section: Discussionmentioning

confidence: 53%

“…It is widely accepted that H. pylori infection accounts for more than 95% of gastric cancers, and the prevalence of strictly defined H. pylori-negative gastric cancer is extremely low in Japanese patients (reported as 0.66 and 0.42% in 2 separate studies) [3,4]. Recently, the use of H. pylori eradication therapy has increased worldwide [5,6]. In 2013, the Japanese health insurance system approved the use of eradication therapy for H. pylori-induced gastritis.…”

Section: Introductionmentioning

confidence: 99%

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Gastric Cancer with Submucosal Invasion after Successful Helicobacter pylori Eradication: A Propensity Score-Matched Analysis of Patients with Annual Patient Endoscopic Survey

et al. 2018

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Background and Aim: The incidence of gastric cancer occurring after successful Helicobacter pylori eradication has been increasing. We aimed to clarify the influence of eradication therapy on the ability to diagnose early gastric cancer after successful H. pylori eradication in patients who underwent annual endoscopic screening. Methods: A total of 220 patients (179 men; mean age 71.0 years) had differentiated-type early gastric cancer that was discovered through annual endoscopic screening. Patients were categorized into 2 groups: the H. pylori-eradicated group (n = 81) and the non-eradicated control group (n = 139). After matching patients by propensity scores, we retrospectively analyzed the clinicopathological characteristics of 162 patients (81 patients in each group). Furthermore, we compared the characteristics of gastric cancer with submucosal invasion between the 2 groups. Results: The prevalence of early gastric cancer with submucosal invasion was significantly higher in the eradicated group than in the control group, both before propensity score matching (16.0 vs. 7.2%, respectively; p = 0.038) and after propensity score matching of 81 pairs (16.0 vs. 4.9%, respectively; p = 0.021). In the comparative analysis of gastric cancer with submucosal invasion, there was no difference between the 2 groups with respect to factors influencing the ability to diagnose its presence endoscopically. Conclusion: H. pylori eradication therapy increased the prevalence of differentiated-type gastric cancer with submucosal invasion despite patients’ completion of annual endoscopic screening after eradication.

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Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Gastric Cancer with Submucosal Invasion after Successful Helicobacter pylori Eradication: A Propensity Score-Matched Analysis of Patients with Annual Patient Endoscopic Survey

et al. 2018

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“…Consensus guidelines within the US recommend eradication of H pylori when detected, using a multi‐drug antibiotic regimen and subsequent re‐testing for confirmation of eradication . In countries with high prevalence of both H pylori and gastric cancer, such as Japan, H pylori eradication is a public health initiative, in order to decrease cancer‐related mortality . Yet despite its class 1 carcinogenic status, mass eradication of H pylori is not without controversy.…”

Section: Introductionmentioning

confidence: 99%

Oesophageal and proximal gastric adenocarcinomas are rare after detection of Helicobacter pylori infection

Kumar

Metz

Ginsberg

et al. 2020

Aliment Pharmacol Ther

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Summary Background Helicobacter pylori infection is the most important risk factor for non‐proximal gastric adenocarcinoma, yet some posit it is protective against oesophageal adenocarcinoma and proximal gastric cancers. Aims To evaluate the incidence of and risk factors for future oesophageal and proximal gastric cancers, utilizing the largest North American cohort of patients with previously identified H pylori. Also to identify whether treatment and eradication of H pylori alter future oesophageal and proximal gastric cancer risk. Methods Retrospective cohort study within the Veterans Administration of 36 803 patients (median age 60.4 years; 91.8% male) with confirmed H pylori between 01 January 1994 and 31 December 2018. Primary outcome was diagnosis of future oesophageal and proximal gastric cancers. A time to event with competing risk analysis was performed, evaluating patient factors and whether the patient received H pylori treatment. Secondary analysis of those treated evaluated whether confirmed eradication was associated with cancer. Results The cumulative incidence of oesophageal and proximal gastric cancers 5, 10 and 15 years after H pylori detection was 0.145%, 0.26% and 0.34%. Risk of future oesophageal or proximal gastric cancer was similar amongst whites (reference), African Americans (SHR 0.87, 95%CI 0.57‐1.43) and American Indians (SHR 1.31, 95%CI 0.18‐9.60) but substantially reduced in those of Asian (no cases amongst 213 H pylori positive) or native Hawaiian origin (no cases amongst 295 H pylori positive) (P < .001). Increasing age (SHR 1.17 per 5 years, 95% CI: 1.09‐1.25, P < 0.001) and smoking (SHR 2.06, 95% CI: 1.33‐3.18, P = 0.001) were associated with oesophageal and proximal gastric cancers. Neither treatment of H pylori nor eradication status were associated with cancer (P > 0.20). Conclusions In the largest study of US patients with H pylori, we demonstrate that rates of oesophageal and proximal gastric cancers after treatment of H pylori are low. Older age, and smoking are associated with future cancer, whilst Asian or Native Hawaiian race are protective. H pylori treatment and eradication are not associated with future cancer.

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“…In 2014, The International Agency for Research on Cancer (IARC) Working Group recommended H. pylori eradication as a strategy for preventing gastric cancer [4]. It encouraged all countries to explore the possibility of introducing population-based H. pylori screening and treatment programs adjusted to local healthcare environments and needs [5].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Tolerability of Second-Line Metronidazole Triple Therapy Using Vonoprazan for Helicobacter pylori Eradication in Japan—Comparative Study: Vonoprazan vs. Proton Pump Inhibitors

Ohtaka¹,

Miura²,

Hanawa³

et al. 2018

OJGas

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Aim: To investigate the efficacy and tolerability of second-line metronidazole triple therapy with vonoprazan (VPZ) for Helicobacter pylori (H. pylori).Methods: We retrospectively reviewed medical records of patients who experienced clarithromycin triple therapy failure and were treated with secondline (20 mg VPZ (n = 274)/30 mg lansoprazole (n = 323) or 10 mg rabeprazole (n = 141) twice daily, 750 mg amoxicillin twice daily, 250 mg metronidazole twice daily for 7 days) eradication therapies. Successful eradication rates were compared between two groups: those receiving VPZ and those receiving a proton pump inhibitor (PPI). Adverse events were also investigated. Results: Successful second-line eradication rates according to ITT analysis and PP analysis, respectively, were 79.9% and 92.4% for VPZ therapy and 83.6% and 93.3% for PPI therapy. There were no significant differences between treatment groups. The eradication rates in those who had received first-line VPZ therapy previously according to ITT and PP analysis were 75.2% and 88.1%, respectively; in contrast, values were 82.5% and 95.4%, respectively, for those who had received first-line PPI therapy previously. In second-line therapy, the overall adverse event rate for VPZ therapy was the same as for PPI therapy. Conclusions: The efficacy and tolerability of metronidazole-containing second-line triple therapy with VPZ or a PPI were equivalent.How to cite this paper: Ohtaka, M., Miura, M., Hanawa, M.,

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Effect on Helicobacter pylori eradication therapy against gastric cancer in Japan

Cited by 102 publications

References 16 publications

Gastric Cancer with Submucosal Invasion after Successful Helicobacter pylori Eradication: A Propensity Score-Matched Analysis of Patients with Annual Patient Endoscopic Survey

Gastric Cancer with Submucosal Invasion after Successful Helicobacter pylori Eradication: A Propensity Score-Matched Analysis of Patients with Annual Patient Endoscopic Survey

Oesophageal and proximal gastric adenocarcinomas are rare after detection of Helicobacter pylori infection

Efficacy and Tolerability of Second-Line Metronidazole Triple Therapy Using Vonoprazan for Helicobacter pylori Eradication in Japan—Comparative Study: Vonoprazan vs. Proton Pump Inhibitors

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