DDW 2017: News in Gastroenterology - Upper Gastrointestinal Disorders

DDW 2017. 971: AGE OF HELICOBACTER PYLORI ERADICATION AND SUBSEQUENT RISK OF GASTRIC CANCER DEVELOPMENT: A POPULATION-BASED STUDY

Results: Among the 63,605 eligible HP-infected subjects (median age 54.8 years, 46.6% male) who had received a course of clarithromycin-based triple therapy, 169 (0.27%) developed GC with a median follow-up of 7.6 years (Incidence: 3.48 per 10,000 person-years). The incidence of gastric cancer in the youngest age group (<40 years) was very low (0.42 per 10,000 person-years) whereas the corresponding incidence rates in the 40-60 and >60-year age groups were 2.12 and 7.12 per 10,000 person-years, with a significant difference among the three groups (log rank p<0.001; Figure). When compared with the group who received HP therapy <40 years, there was a progressive increase in the risk of cancer in the older age groups (age group 40-60: HR 5.6, 95% CI 1.7-17.8; age group ≥60: HR 17.1, 95% CI 5.4-54.8).

Conclusions: In this large population-based study, we showed that the risk of gastric cancer development was very low in individuals who had received HP therapy before the age of 40. For prevention of gastric cancer, HP eradication shall be given before the age of 40.

CARE Faculty Perspective: The goal of this study was to determine the risk of developing gastric cancer after receiving HP eradication therapy among different age groups in a large cohort of HP infected subjects. It appears that patients over 60 have the highest rate of developing gastric cancer. In order to prevent this, HP eradication treatment should be given before the age of 40.