Eradication of Helicobacter pylori, an established risk factor for the development of gastric cancer, did not significantly reduce the incidence of metachronous gastric carcinoma in patients who underwent endoscopic resection in a recent clinical trial.
Helicobacter pylori is a class 1 carcinogen for gastric cancer. Eradication of H. pylori infection is important to prevent later gastric pathology including cancer. Availability of endoscopy has resulted in early detection of H. pylori-associated gastric cancers and gastric dysplasia. With early detection endoscopic resection of these lesions are possible. It is not clear based on discrepant results in the literature if once patients develop precancerous changes of the gastric mucosa eradication of active H. pylori infection along with surgical treatment helps reduce the chance for future gastric cancer. The current study demonstrated that therapy to eradicate H. pylori in infected patients with gastric cancer or dysplasia undergoing endoscopic resection did not prevent later development of gastric malignancy. This study adds further evidence to the existing literature that emphasizes the need for early therapy of H. pyloriinfection before precancerous lesions, dysplasia and cancer develop
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Article By: Herbert L. DuPont, MD, MACP Infectious Disease News Editorial Board member