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Title: Effects of Helicobacter pylori treatment on gastric cancer incidence and mortality in subgroups.
Authors: Li WQ,  Ma JL,  Zhang L,  Brown LM,  Li JY,  Shen L,  Pan KF,  Liu WD,  Hu Y,  Han ZX,  Crystal-Mansour S,  Pee D,  Blot WJ,  Fraumeni JF Jr,  You WC,  Gail MH
Journal: J Natl Cancer Inst
Date: 2014 Jul
Branches: BB, OD
PubMed ID: 24925350
PMC ID: PMC4067110
Abstract: Among 2258 Helicobacter pylori-seropositive subjects randomly assigned to receive one-time H. pylori treatment with amoxicillin-omeprazole or its placebo, we evaluated the 15-year effect of treatment on gastric cancer incidence and mortality in subgroups defined by age, baseline gastric histopathology, and post-treatment infection status. We used conditional logistic and Cox regressions for covariable adjustments in incidence and mortality analyses, respectively. Treatment was associated with a statistically significant decrease in gastric cancer incidence (odds ratio = 0.36; 95% confidence interval [CI] = 0.17 to 0.79) and mortality (hazard ratio = 0.26; 95% CI = 0.09 to 0.79) at ages 55 years and older and a statistically significant decrease in incidence among those with intestinal metaplasia or dysplasia at baseline (odds ratio = 0.56; 95% CI = 0.34 to 0.91). Treatment benefits for incidence and mortality among those with and without post-treatment infection were similar. Thus H. pylori treatment can benefit older members and those with advanced baseline histopathology, and benefits are present even with post-treatment infection, suggesting treatment can benefit an entire population, not just the young or those with mild histopathology.