Navigation Links
Study identifies factors associated with eradication of bacteria linked to gastric cancer

In an analysis of the results of interventions to eradicate the bacterium Helicobacter pylori (a risk factor for gastric cancer) in seven diverse community populations in Latin America, researchers found that geographic site, demographic factors, adherence to initial therapy and infection recurrence may be as important as the choice of antibiotic regimen in H pylori eradication interventions, according to a study appearing in the February 13 issue of JAMA.

"Gastric adenocarcinoma is the second leading cause of cancer death worldwide. Although gastric cancer rates are declining in some areas, the number of deaths is expected to increase over the coming decades due to growing and aging populations in high-incidence regions such as Latin America and eastern Asia. Helicobacter pylori infects more than half of the world's adult population, and chronic infection with this bacterium is the dominant risk factor for gastric cancer, accounting for an estimated two-thirds of all cases globally," according to background information in the article. "The feasibility of large-scale programs is uncertain and success in specific populations will depend on the efficacy of the antibiotic regimen used and the risk of recurrent infection following eradication."

Douglas R. Morgan, M.D., M.P.H., of Vanderbilt Medical Center, Nashville, Tenn., and colleagues estimated risk of H pylori recurrence and assessed factors associated with successful eradication 1 year after treatment with one of three regimens. The study included 1,463 participants, 21 to 65 years of age from 7 Latin American communities, who were treated for H pylori and observed between September 2009 and July 2011. Potential participants were selected using a census of households (Colombia, Costa Rica, Nicaragua), a large public clinic registry (Chile), or household recruitment (Honduras and 2 sites in Mexico). Participants were randomized to 1 of 3 treatment groups: 14-day lansoprazole, amoxicillin, and clarithromycin (triple therapy); 5-day lansoprazole and amoxicillin followed by 5-day lansoprazole, clarithromycin, and metronidazole (sequential); or 5-day lansoprazole, amoxicillin, clarithromycin, and metronidazole (concomitant).

Of the 1,133 participants who were urea breath test (UBT; a diagnostic procedure used to identify the presence of H pylori) negative following initial treatment, 1,091 had a 1-year UBT result, of whom 125 had become UBT positive, a recurrence risk of 11.5 percent. The recurrence risk ranged from 6.8 percent in Costa Rica to 18.1 percent in Colombia. The researchers found that recurrence at 1 year was significantly associated with study site, number of children in the household, and nonadherence to therapy, but not with treatment assignment.

In the primary analysis of treatment effectiveness based on the 1,340 participants with definitive 1-year UBT results, the estimated 1-year eradication success rate was 80.4 percent for triple therapy, 79.8 percent for sequential therapy, and 77.8 percent for concomitant therapy. Overall effectiveness was 79.3 percent.

"In a single-treatment course analysis that ignored the effects of re-treatment, the percentage of UBT-negative results at 1 year was 72.4 percent and was significantly associated with study site, adherence to initial therapy, male sex, and age. One-year effectiveness among all 1,463 enrolled participants, considering all missing UBT results as positive, was 72.7 percent," the authors write.

"In our current study, adherence, study site, sex, and age were significantly associated with the probability of a successful 1-year outcome. From the public health perspective, a 'one size fits all' intervention strategy may not be optimal."

"Ongoing research initiatives are needed, given the expected increase in the gastric cancer burden in Latin America over the next 2 decades, evidence that H pylori infection is the dominant risk factor, and evidence that eradication reduces gastric cancer risk," the researchers conclude.


Contact: Craig Boerner
JAMA and Archives Journals

Related medicine news :

1. Study shows that problem-solving training helps mothers cope with childs cancer diagnosis
2. Startling Differences in New-Hip Estimates: Study
3. Womens Vitamin D Needs Dont Vary By Race, Study Finds
4. Study shows long-term success rates for eradication of Barretts esophagus after endoluminal therapies
5. Scientists advance the art of magic with a study of Penn and Tellers cups and balls illusion
6. Cut Salt, Save 500,000 U.S. Lives Over a Decade, Study Finds
7. High Blood Pressure in Pregnancy May Predict Later Ills, Study Says
8. If Wife Earns More, Husbands Sexual Performance May Suffer: Study
9. Study finds increase in dance-related injuries in children and adolescents
10. International study suggests improved treatment alternative for lymphoid leukemia
11. Large study shows substance abuse rates higher in teenagers with ADHD
Post Your Comments:
(Date:11/26/2015)... ... November 26, 2015 , ... PRMA Plastic Surgery is updating their ... surgeons performed their 6,000th free flap breast reconstruction surgery! , “What an accomplishment for ... excited to rebuild lives and it’s an honor to have served all of these ...
(Date:11/26/2015)... CA (PRWEB) , ... November 26, 2015 , ... ... a new set of retro-fused, self-animating trailer titles with ProTrailer: Vintage. This newly ... options. These classically-influenced trailer titles work with any font, giving users limitless opportunities ...
(Date:11/26/2015)... , ... November 26, 2015 , ... Indosoft Inc., developer ... of an application server to improve system efficiency and reliability. , The new Q-Suite ... of these standards, the system avoids locking itself into a specific piece of software ...
(Date:11/25/2015)... ... November 25, 2015 , ... As part of ... Empowerment ™ attracts volunteers together who want to combine talents and resources to ... stakeholders in the process. The non-profit launched its first major fundraiser on November ...
(Date:11/25/2015)... ... 25, 2015 , ... Finnleo, a leader in the traditional and far-infrared sauna ... and far-infrared saunas. , For traditional saunas, Finnleo is offering 20% ... wood, and Finnleo uses only European Grade A Nordic White Spruce from sustainably grown ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... , November 26, 2015 /PRNewswire/ ... --> adds "Global ... and "Investigation Report on China Repaglinide ... 2021 forecasts data and information to ... . --> ...
(Date:11/26/2015)... 2015 ) ... "Radioimmunoassay Market by Type (Reagents & Kits, ... Clinical Diagnostic Labs), Application (Research, Clinical Diagnostics), ... report to their offering. --> ... of the "Radioimmunoassay Market by Type ...
(Date:11/25/2015)... Nov. 26, 2015  The total global healthcare industry is ... 2015-2016. Latin America has the highest ... (excluding Japan ), is second with growth ... to face increased healthcare expenditure. In 2013-2014, total government funded ... 43.5% in 2008-2009 to 41.2% in 2013-2014. In real terms, ...
Breaking Medicine Technology: