July 21, 2011

Local Studies: Best Bet for Stopping Gastric Cancer?

(Ivanhoe Newswire) -- In the largest study of its kind, researchers say different populations of people need different therapies to get rid of H. pylori, which is the primary cause of gastric cancer.

According to the International Agency for Research on Cancer, stomach cancer was the fourth most common cancer and the second-leading cause of cancer death in the world in 2008. About 72 percent of new cases occur in developing countries.

The current study, which was conducted at seven sites across Latin America, found that a standard three-drug regimen for treating H. pylori is more effective than either of two four-drug regimens that proved to be better in studies conducted in Europe and Asia. H. pylori is the bacterium known to cause peptic ulcers.

"This study turns recent literature a bit on its head," study coauthor William D. Chey, M.D., of the University of Michigan, was quoted as saying. "Specifically, virtually all other randomized, controlled trials that have tested the four-drug therapy, either sequentially over ten days or concomitantly over five days, have found it superior."

However, investigators point out that most of that research was conducted in Taiwan and Italy. This new study suggests that H. pylori eradication approaches need to be validated locally rather than relying of findings from studies of other populations. The authors suspect that geographic variations of H. pylori's resistance to antibiotics may account for the discrepancies.

There is a small but controversial body of evidence that suggests H. pylori infection may offer some health benefits. For example, some say it may reduce rates of asthma and allergies and lower the rates of esophageal cancer.

"The ultimate goal is to advance the discussion about whether we should approach gastric cancer prevention by mass eradication programs for H. pylori," lead author E. Robert Greenberg, M.D., an epidemiologist with the SWOG Statistical Center and the Fred Hutchinson Cancer Research Center in Seattle, Wash., was quoted as saying. "There's lots of thinking that needs to be done and information that needs to be gathered before that decision is made."

SOURCE: The Lancet, July 2011