Helicobacter pylori Update: Gastric Cancer, Reliable Therapy, and Possible Benefits

• Published in: Gastroenterology (New York, N.Y. 1943) Vol. 148; no. 4; pp. 719 - 731.e3
• Main Author: Graham, David Y
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2015
• Subjects: Adenocarcinoma - etiology; Adenocarcinoma - microbiology; Antacids - therapeutic use; Anti-Bacterial Agents - therapeutic use; Asthma - epidemiology; Bacteria; Barrett's Esophagus; Esophageal Adenocarcinoma; Esophageal Neoplasms - etiology; Gastroenterology and Hepatology; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter Infections - epidemiology; Helicobacter pylori; Humans; Obesity - epidemiology; Prevention; Proton Pump Inhibitors - therapeutic use; Stomach Cancer; Stomach Neoplasms - microbiology; Stomach Cancer; Prevention; Barrett's Esophagus; CI; Esophageal Adenocarcinoma; Bacteria; confidence interval
• ISSN: 0016-5085; 1528-0012
• DOI: 10.1053/j.gastro.2015.01.040

Helicobacter pylori infection contributes to the development of diverse gastric and extragastric diseases. The infection is necessary but not sufficient for the development of gastric adenocarcinoma. Its eradication would eliminate a major worldwide cause of cancer death, therefore there is much interest in identifying how, if, and when this can be accomplished. There are several mechanisms by which H pylori contributes to the development of gastric cancer. Gastric adenocarcinoma is one of many cancers associated with inflammation, which is induced by H pylori infection, yet the bacteria also cause genetic and epigenetic changes that lead to genetic instability in gastric epithelial cells. H pylori eradication reduces both. However, many factors must be considered in determining whether treating this bacterial infection will prevent cancer or only reduce its risk—these must be considered in designing reliable and effective eradication therapies. Furthermore, H pylori infection has been proposed to provide some benefits, such as reducing the risks of obesity or childhood asthma. When tested, these hypotheses have not been confirmed and are therefore most likely false.