Clinical Gastroenterology Vol.27 No.3(1-2)

Theme Carcinogenesis Based on H. pylori-associated Gastritis -- Is Cancer Control Possible by the Eradication ?
Title Current State and Future Development of H. pylori Eradication in Clinical Practice
Publish Date 2012/03
Author Mototsugu Kato Division of Endoscopy, Hokkaido University Hospital
Author Shoko Ono Division of Endoscopy, Hokkaido University Hospital
Author Katsuhiro Mabe Department of Gastroenterology, Hokkaido University Graduate School of Medicine
Author Yuichi Shimizu Department of Gastroenterology, Hokkaido University Graduate School of Medicine
Author Masahiro Asaka Department of Cancer Prevention, Hokkaido University Graduate School of Medicine
[ Summary ] Gastric cancer is associated with H. pyloriinfection. There have been studies concerning the preventive effect of H. pylori eradication in the development of gastric cancer. Japanese cohort studies have indicated H. pylori eradication reduces the incidence of gastric cancer in cases with a high incidence of gastric cancer. H. pylori eradication lowered the incidence of metachronous cancer after endoscopic resection of early gastric cancer, as observed in a Japanese randomized controlled study (RCT). Meta-analysis of RCT suggested that the incidence of primary gastric cancer was suppressed by H. pylori eradication. In guidelines established by the Japanese Society of Helicobacter Research, an indication forH. pylori eradication therapy is H. pylori infection. The Japanese Public Insurance Program covers treatment for four related diseases. The strategy for elimination of gastric cancer in Japan should consist of H. pylori eradication as the primary prevention strategy as well as surveillance of gastric cancer using endoscopy as a secondary preventive strategy.
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