Helicobacter pylori infection reduces likelihood of death from advanced cancer: A longitudinal analysis from the Japanese DAIKO prospective cohort study

BackgroundParadoxically, patients with advanced stomach cancer who are Helicobacter pylori-positive (HP+) have a higher survival rate than those who are HP-. This finding suggests that HP infection has beneficial effects for cancer treatment. Present study examines whether HP+ individuals have a lower likelihood of death from cancer than those who are HP-.Methods and findingsProspective cohort data (n = 4,982 subjects enrolled in the DAIKO study between 2008-2010) was used to assess whether anti-HP antibody status as a surrogate for past-present HP infection was associated with cancer incidence. The median age in the primary registry was 53 years-old (range 34-69 years-old). Over the 8-year observation period there were 234 (4.7%) cancer cases in the cohort and 88 (1.8%) all-cause deaths. Urine anti-HP antibody data was available for all but one participant (n = 4,981; 99.97%). The number of HP+ and HP- individuals was 1,826 (37%) and 3,156 (63%), respectively. Anti-HP antibody distribution per birth year revealed that earlier birth year was associated with higher HP+ rates. To remove confounding factors associated with birth year, a birth year-matched cohort (n = 3,376) was generated for subsequent analyses. All-cancer incidence was significantly higher in HP+ individuals than those who were HP- (p=0.00328), whereas there was no significant difference in the cancer death rate between HP+ and HP- individuals (p=0.888). Strikingly, we found that HP+ individuals who developed cancer had a better survival rate than would be expected based on cancer incidence. These results suggest that cancer patients who are HP+ may have a higher likelihood of survival than those who are HP-. Cox regression analysis for prognostic factors revealed that the hazards ratio of HP+ was 1.59-fold (95%CI 1.17-2.26) higher than HP- in all-cancer incidence.ConclusionsPotential systemic effects of HP+ status may contribute to reduced likelihood of death for patients with cancer.Data Availability StatementThe data cannot be shared publicly as data sharing is not permitted according to Japanese Government data protection policies. Requests for data analysis may be accepted anonymously and conditionally upon IRB approval from Iwate Medical University and Nagoya University Graduate School of Medicine.FundingThis study is supported by Grants-in-Aid for Scientific Research for Priority Areas of Cancer (No. 17015018); Grants-in-Aid for Innovative Areas (No. 221S0001); and the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant (No. 19K09130 and No. 16H06277 [CoBiA]) from the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Competing interestsThe authors declare that no competing interests exist.Author summaryWhy was this study done?> Although HP infection is a major cause of gastric diseases including cancer, how HP infection affects prolonged survival of advanced gastric cancer patients is unknown.> Reports of studies carried out in different countries and regions revealed that advanced gastric cancer patients who are HP+ exhibited prolonged post-treatment survival, even though the genetic background of patients, HP strains, and cancer treatment procedures differed.> Since most advanced gastric cancer patients underwent gastrectomy, the favorable prognosis of HP+ patients after multidisciplinary treatment may be due to putative systematic mechanisms associated with HP infection.> If putative systemic mechanisms associated with HP infection reduce the likelihood of death due to cancer, the cancer survival rate in the HP+ population should be lower than that for the HP- population.What did the researchers do and find?> Using data from the DAIKO prospective cohort study in Nagoya, Japan, we analyzed the association between anti-HP antibody status, cumulative cancer incidence and all-cause and cancer-specific deaths.> The HP+ rate increased as birth year decreased. Thus, matching based on birth year between 1935 and 1975 was performed to correct for confounding factors associated with birth year.> Despite a significantly higher all-cancer incidence for HP+ individuals compared to those who were HP-, no difference in the all-cause and cancer death rate was observed between HP+ and HP- individuals.What do these findings mean?> HP+ individuals are less susceptible to death relative to their incidence of cancer.> Patients with advanced stage cancer who are HP+ may have a better treatment response/tolerance than those who are HP-.> Additional longitudinal analyses are warranted to evaluate the effect of HP+ status on prolonged survival of patients with advanced-stage cancer.

Precision Medicine and Personalized Medicine in Oncology-A Brief Review

Definition: Precision medicine is "an emerging approach for disease treatmentand prevention that takes into account individual variability in genes,environment, and lifestyle for each person."[1] This method would make it easierfor physicians and experts to more reliably assess which care and preventivemethods will function with which classes of individuals with a specific illness. Incomparison to a one-size-fits-all strategy, infectious management and preventionmethods are designed for the average person, with the variations betweenpeople less taken into account.Precision Medicine in Cancer: According to Cancer National Institute DataThe rate of new cases of cancer (cancer incidence) is 442.4 per 100,000 men andwomen per year (based on 2013–2017 cases). The cancer death rate (cancermortality) is 158.3 per 100,000 men and women per year (based on 2013–2017deaths) Standard therapies, such as chemotherapy, Surgery or radiation, aresuccessful with only a fraction of the patient population regardless tumorheterogeneity. Tumors may have common genetic factors, and in one patientversus another, they may express different proteins. It is clear that therapies ofcancer will result in tremendous patient benefits, and this has started to beunderstood by corporations and regulatory agencies. However, if PPM is tobecome part of routine cancer treatment, larger improvements to the healthcareand insurance processes must be discussed. [2]

The Role of Vitamin D and Sunlight Incidence in Cancer

Background:Vitamin D (VD) deficiency affects individuals of different ages in many countries. VD deficiency may be related to several diseases, including cancer.Objective:This study aimed to review the relationship between VD deficiency and cancer.Methods:We describe the proteins involved in cancer pathogenesis and how those proteins can be influenced by VD deficiency. We also investigated a relationship between cancer death rate and solar radiation.Results:We found an increased bladder cancer, breast cancer, colon-rectum cancer, lung cancer, oesophagus cancer, oral cancer, ovary cancer, pancreas cancer, skin cancer and stomach cancer death rate in countries with low sunlight. It was also observed that amyloid precursor protein, ryanodine receptor, mammalian target of rapamycin complex 1, and receptor for advanced glycation end products are associated with a worse prognosis in cancer. While the Klotho protein and VD receptor are associated with a better prognosis in the disease. Nfr2 is associated with both worse and better prognosis in cancer.Conclusion:The literature suggests that VD deficiency might be involved in cancer progression. According to sunlight data, we can conclude that countries with low average sunlight have high cancers death rate. New studies involving transcriptional and genomic data in combination with VD measurement in long-term experiments are required to establish new relationships between VD and cancer.

Application of Neutrosophic Logic to Evaluate Correlation between Prostate Cancer Mortality and Dietary Fat Assumption

This paper presents an epidemiological study on the dietary fat that causes prostate cancer in an uncertainty environment. To study this relationship under the indeterminate environment, data from 30 countries are selected for the prostate cancer death rate and dietary fat level in the food. The neutrosophic correlation and regression line are fitted on the data. We note from the neutrosophic analysis that the prostate cancer death rate increases as the dietary fat level in the people increases. The neutrosophic regression coefficient also confirms this claim. From this study, we conclude that neutrosophic regression is a more effective model under uncertainty than the regression model under classical statistics. We also found a statistical correlation between dietary fat and prostate cancer risk.

State rurality does not increase risk of prostate cancer death.

119 Background: Prostate cancer is the third most common cancer among men. PSA based screening for prostate cancer was introduced in the 1980s and resulted in a significant decline in prostate cancer mortality. Current AUA guidelines recommend PSA screening in average risk patients between the ages of 55 and 69. There are public health concerns in rural areas of the United States (US) potentially due to decreased access of care. In this study, we sought to evaluate the prevalence of prostate cancer screening and death rate in rural communities within the US. Methods: After IRB approval, data was collected from several different sources. Annual prostate cancer death rate (2011-2015) was obtained from the American Cancer Society. Data from the Behavioral Risk Factor Surveillance System regarding prostate cancer screening during this time interval was acquired. Data regarding populations was obtained from the US Census. Descriptive analyses were used to describe the population and Pearson Correlation Coefficient to determine screened, death rates and rurality correlations. All analyses were completed using SPSS. Results: The median percent of US population residing in rural and urban areas was 25.8% (IQR 22.1%) and 73.8% (IQR 22.1%), respectively. The median percent of male patients screened using PSA 50 years and older was 56.2% (IQR 7.0%). The median death rate (per 100,000) from prostate cancer per state was 19.5 (IQR 1.7%). Prostate cancer death rate was found to have no correlation to percent of population screened (p = 0.29) and percent rurality (p = 0.98). The percent rural population versus percent of screened men over the age of 50 was also not significant (p = 0.20). Conclusions: Neither death rate nor screening rate for prostate cancer using PSA demonstrated a significant association with the percent of patient’s living in rural communities. This is evidence that within the US, rural communities are following guidelines for PSA screening for prostate cancer and therefore there is no discrepancy in prostate cancer death in these areas compared to urban. This study is evidence that the barriers that may be associated with living in rural communities, such as decreased access to healthcare do not translate into worse outcomes related to prostate cancer.