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Clinical Trials Update
November 26, 2019

H pylori Treatment May Reduce Long-term Gastric Cancer Risk

JAMA. 2019;322(20):1948. doi:10.1001/jama.2019.18424

Short-term treatment for Helicobacter pylori infection and vitamin or garlic supplementation may afford long-term protection against gastric cancer among people at high risk, according to a BMJ follow-up study.

H pylori treatment was associated with a long-term decrease in gastric cancer risk.

The 3365 study participants lived in a rural area of China known for having one of the world’s highest gastric cancer mortality rates. The 2258 participants who were seropositive for antibodies to H pylori were randomly assigned to 3 interventions: treatment with amoxicillin and omeprazole for 2 weeks, vitamin (C, E, and selenium) supplementation for 7.3 years, garlic supplementation for 7.3 years, or their placebos. The 1107 participants who were H pylori seronegative were randomly assigned to vitamin supplementation, garlic supplementation, or their placebos.

During 22.3 years of follow-up, there were 151 incident cases of gastric cancer and 94 gastric cancer deaths, most of which occurred in participants who tested positive for H pylori at baseline. H pylori treatment and vitamin supplementation were associated with decreased gastric cancer incidence and mortality. Garlic supplementation was associated with decreased gastric cancer mortality only.