H pylori Eradication Treatment May Reduce Gastric Cancer Risk

Patients with Helicobacter pylori infection and a family history of gastric cancer among first-degree relatives may have a reduced risk of gastric cancer if they received treatment to eradicate H pylori, according to findings of a double-blind, placebo-controlled trial.

The researchers screened 3100 first-degree relatives of patients with gastric cancer. Of these participants, 1838 with H pylori infection were randomly assigned to receive either eradication therapy or placebo. Eradication therapy consisted of lansoprazole, 30 mg; amoxicillin, 1000 mg; and clarithromycin, 500 mg, each taken twice daily for 7 days.


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A total of 832 participants from the treatment group and 844 participants from the placebo group were included in the modified intention-to-treat population for the analysis of gastric cancer development.

During a median follow-up of 9.2 years, 10 participants (1.2%) in the treatment group and 23 participants (2.7%) in the placebo group developed gastric cancer. Among the 10 participants in the treatment group who developed gastric cancer, 5 had persistent H pylori infection.

Of the 608 participants whose H pylori infection was eradicated, 5 (0.8%) developed gastric cancer. Of the 979 participants whose H pylori infection persisted, 28 (2.9%) developed gastric cancer.

Adverse events were mild and were more common in the treatment group (53.0%) than in the placebo group (19.1%).

—Colleen Murphy


Choi IJ, Kim CG, Lee JY, et al. Family history of gastric cancer and Helicobacter pylori treatment. N Engl J Med. 2020;382(5):427-436. doi:10.1056/NEJMoa1909666.