World trends for H. pylori eradication therapy and gastric cancer prevention strategy by H. pylori test-and-treat

Aim. The aim of this literature review is to generalize existing approaches to the pathogenetic treatment of gastritis as a basis for the prevention of gastric cancer, as well as to submit a resolution of a scientific symposium that brought together gastroenterologists from a number of CIS countries.Background. H. pylori infection is widespread in CIS countries. The proportion of infected adults in the population ranges from 60 % to over 90 %. This causes a high incidence of chronic gastritis and other diseases associated with H. pylori. In 2012, gastric cancer was recognized as the 3rd leading malignant disease in the Kyrgyz Republic and the Republic of Uzbekistan, 5th — in Belarus and Kazakhstan, 6th — in Armenia and the Russian Federation. According to the standardized cancer mortality rate, gastric cancer takes the 1st place in Kyrgyzstan and Uzbekistan, 2nd — in Belarus, 3rd — in Kazakhstan, and 4th — in Armenia and Russia. In every case of H. pylori detection, it is important to make a decision about the expediency of eradication therapy. This is particularly significant, since H. pylori eradication has been recognized as an effective method of gastric cancer prevention. In addition, H. pylori eradication therapy in patients suffering from chronic gastritis with dyspepsia symptoms serves as the firstchoice therapy that allows patients with dyspepsia resulting from H. pylori infection to be excluded. The choice of the H. pylori eradication therapy scheme is determined by the protocols (standards) of patient management accepted in the respective CIS country. A high efficacy of H. pylori infection eradication is shown to be provided by bismuthcontaining schemes.Conclusion. Opportunistic screening of H. pylori is carried out by general practitioners, district physicians, gastroenterologists and other specialists. The most effective method of gastric cancer prevention is the eradication therapy of H. pylori infection in chronic gastritis. The maximal positive potential of such a therapy is realized when it is performed before the atrophic changes of the gastric mucosa have appeared.

Download Full-text

Sa1134 H. pylori Antibiotic Resistance in Central America: Implications for Patient Care, Gastric Cancer Prevention and Antibiotic Stewardship

Gastroenterology ◽

10.1016/s0016-5085(16)30907-6 ◽

2016 ◽

Vol 150 (4) ◽

pp. S252

Author(s):

Vivian Ortiz ◽

Ricardo L. Dominguez ◽

Charlotte B. Cherry ◽

Dagoberto Estevez ◽

Dawn Israel ◽

...

Keyword(s):

Gastric Cancer ◽

Antibiotic Resistance ◽

Patient Care ◽

Cancer Prevention ◽

Central America ◽

Antibiotic Stewardship ◽

Gastric Cancer Prevention ◽

H Pylori

Download Full-text

Gastric Cancer Prevention: Beyond H. pylori

The Singapore Family Physician ◽

10.33591/sfp.47.7.up1 ◽

2021 ◽

Vol 47 (7) ◽

Keyword(s):

Gastric Cancer ◽

Cancer Prevention ◽

Gastric Cancer Prevention ◽

H Pylori

Download Full-text

Test and treat or test and scope for Helicobacter pylori infection. Any change in gastric cancer prevention?

Alimentary Pharmacology & Therapeutics ◽

10.1046/j.1365-2036.17.s2.13.x ◽

2003 ◽

Vol 17 ◽

pp. 82-88 ◽

Cited By ~ 5

Author(s):

R. M. Mc Loughlin ◽

S. S. Sebastian ◽

H. J. O'Connor ◽

M. Buckley ◽

C. A. O'Morain

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Cancer Prevention ◽

Helicobacter Pylori Infection ◽

Test And Treat ◽

Gastric Cancer Prevention

Download Full-text

Efficacy and Long-Term Safety of H. pylori Eradication for Gastric Cancer Prevention

Cancers ◽

10.3390/cancers11050593 ◽

2019 ◽

Vol 11 (5) ◽

pp. 593 ◽

Cited By ~ 10

Author(s):

Jyh-Ming Liou ◽

Yi-Chia Lee ◽

Emad M. El-Omar ◽

Ming-Shiang Wu

Keyword(s):

Gastric Cancer ◽

Antibiotic Resistance ◽

Cohort Studies ◽

Prospective Cohort ◽

Meta Analysis ◽

Eradication Therapy ◽

Prospective Cohort Studies ◽

Gastric Cancer Prevention ◽

H Pylori

Helicobacter pylori (H. pylori) has been shown to be a causal factor of gastric cancer in cohort studies and animal models. Meta-analysis of case-control studies nested within prospective cohorts showed that H. pylori infection was associated with a 5.9-fold increased risk of non-cardia gastric cancer. Prospective cohort studies showed that gastric cancer developed in 1–4% of H. pylori-infected subjects. Gastric cancer was successfully induced in Mongolian gerbils and insulin-gastrin (INS-GAS) transgenic mice after inoculation of H. pylori. Meta-analysis of randomized control trials also showed that eradication of H. pylori may reduce the risk of gastric cancer. However, there are several concerns regarding the widespread use of antibiotics to prevent gastric cancer, including the emergence of antibiotic resistance and the perturbation of gut microbiota after H. pylori eradication. Recent studies showed that eradication of H. pylori resulted in an increase in the bacterial diversity and restoration of the relative abundance of other bacteria to levels similar to H. pylori non-infected subjects in the gastric microbiota. The administration of antibiotics may also alter the composition of intestinal microbiota. The α-diversity and β-diversity of fecal microbiota are significantly altered immediately after H. pylori eradication but are gradually restored to levels similar to those before therapy. Yet, the rate of recovery varies with regimens. The diversity was restored at week 8 after triple therapy but was not yet fully recovered at 1 year after concomitant and quadruple therapies. Some studies showed that supplementation of probiotics may reduce the dysbiosis during H. pylori eradication therapy. Although some earlier studies showed high levels of macrolide resistance after triple therapy, recent studies showed that the increased antibiotic resistance rate may be restored 2–12 months after eradication therapy. These results collectively provide evidence of the long-term safety of H. pylori eradication. Yet, more prospective cohort studies and randomized trials are warranted to assess the efficacy and long-term safety of H. pylori eradication for gastric cancer prevention.

Download Full-text