Effect of Helicobacter pylori Eradication Therapy on the Incidence of Noncardia Gastric Adenocarcinoma in a Large Diverse Population in the United States
High-quality data regarding the effect of Helicobacter pylori eradication on the risk of noncardia gastric adenocarcinoma (NCGA) remain limited in the United States. We investigated the incidence of NCGA after H pylori eradication therapy in a large, community-based US population. We performed a ret...
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| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 2023-08, Vol.165 (2), p.391-401.e2 |
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| container_title | Gastroenterology (New York, N.Y. 1943) |
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| creator | Li, Dan Jiang, Sheng-Fang Lei, Nan Ye Shah, Shailja C. Corley, Douglas A. |
| description | High-quality data regarding the effect of Helicobacter pylori eradication on the risk of noncardia gastric adenocarcinoma (NCGA) remain limited in the United States. We investigated the incidence of NCGA after H pylori eradication therapy in a large, community-based US population.
We performed a retrospective cohort study of Kaiser Permanente Northern California members who underwent testing and/or treatment for H pylori between 1997 and 2015 and were followed through December 31, 2018. The risk of NCGA was evaluated using the Fine-Gray subdistribution hazard model and standardized incidence ratios.
Among 716,567 individuals with a history of H pylori testing and/or treatment, the adjusted subdistribution hazard ratios and 95% confidence intervals of NCGA for H pylori–positive/untreated and H pylori–positive/treated individuals were 6.07 (4.20–8.76) and 2.68 (1.86–3.86), respectively, compared with H pylori–negative individuals. When compared directly with H pylori–positive/untreated individuals, subdistribution hazard ratios for NCGA in H pylori–positive/treated were 0.95 (0.47–1.92) at |
| doi_str_mv | 10.1053/j.gastro.2023.04.026 |
| format | Article |
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We performed a retrospective cohort study of Kaiser Permanente Northern California members who underwent testing and/or treatment for H pylori between 1997 and 2015 and were followed through December 31, 2018. The risk of NCGA was evaluated using the Fine-Gray subdistribution hazard model and standardized incidence ratios.
Among 716,567 individuals with a history of H pylori testing and/or treatment, the adjusted subdistribution hazard ratios and 95% confidence intervals of NCGA for H pylori–positive/untreated and H pylori–positive/treated individuals were 6.07 (4.20–8.76) and 2.68 (1.86–3.86), respectively, compared with H pylori–negative individuals. When compared directly with H pylori–positive/untreated individuals, subdistribution hazard ratios for NCGA in H pylori–positive/treated were 0.95 (0.47–1.92) at <8 years and 0.37 (0.14–0.97) ≥8 years of follow-up. Compared with the Kaiser Permanente Northern California general population, standardized incidence ratios (95% confidence interval) of NCGA steadily decreased after H pylori treatment: 2.00 (1.79–2.24) ≥1 year, 1.01 (0.85–1.19) ≥4 years, 0.68 (0.54–0.85) ≥7 years, and 0.51 (0.38–0.68) ≥10 years.
In a large, diverse, community-based population, H pylori eradication therapy was associated with a significantly reduced incidence of NCGA after 8 years compared with no treatment. The risk among treated individuals became lower than the general population after 7 to 10 years of follow-up. The findings support the potential for substantial gastric cancer prevention in the United States through H pylori eradication.
[Display omitted]
Helicobacter pylori eradication therapy was associated with a significant reduction in the risk of developing noncardia gastric adenocarcinoma based on results from a large, diverse, community-based population. These findings support the potential for substantial gastric cancer prevention through testing and eradication of Helicobacter pylori in the United States.</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1053/j.gastro.2023.04.026</identifier><identifier>PMID: 37142201</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma - drug therapy ; Adenocarcinoma - epidemiology ; Adenocarcinoma - prevention & control ; Anti-Bacterial Agents - therapeutic use ; Eradication ; Gastric Cancer ; Helicobacter Infections - diagnosis ; Helicobacter Infections - drug therapy ; Helicobacter Infections - epidemiology ; Helicobacter pylori ; Humans ; Incidence ; Prevention ; Retrospective Studies ; Stomach Neoplasms - drug therapy ; Stomach Neoplasms - epidemiology ; Stomach Neoplasms - prevention & control ; United States - epidemiology</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 2023-08, Vol.165 (2), p.391-401.e2</ispartof><rights>2023 AGA Institute</rights><rights>Copyright © 2023 AGA Institute. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-2388e663719f4e084ef57752929d9253a2c470dab382fb17961681f3d894572f3</citedby><cites>FETCH-LOGICAL-c408t-2388e663719f4e084ef57752929d9253a2c470dab382fb17961681f3d894572f3</cites><orcidid>0000-0002-2691-5175</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.gastro.2023.04.026$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37142201$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Dan</creatorcontrib><creatorcontrib>Jiang, Sheng-Fang</creatorcontrib><creatorcontrib>Lei, Nan Ye</creatorcontrib><creatorcontrib>Shah, Shailja C.</creatorcontrib><creatorcontrib>Corley, Douglas A.</creatorcontrib><title>Effect of Helicobacter pylori Eradication Therapy on the Incidence of Noncardia Gastric Adenocarcinoma in a Large Diverse Population in the United States</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>High-quality data regarding the effect of Helicobacter pylori eradication on the risk of noncardia gastric adenocarcinoma (NCGA) remain limited in the United States. We investigated the incidence of NCGA after H pylori eradication therapy in a large, community-based US population.
We performed a retrospective cohort study of Kaiser Permanente Northern California members who underwent testing and/or treatment for H pylori between 1997 and 2015 and were followed through December 31, 2018. The risk of NCGA was evaluated using the Fine-Gray subdistribution hazard model and standardized incidence ratios.
Among 716,567 individuals with a history of H pylori testing and/or treatment, the adjusted subdistribution hazard ratios and 95% confidence intervals of NCGA for H pylori–positive/untreated and H pylori–positive/treated individuals were 6.07 (4.20–8.76) and 2.68 (1.86–3.86), respectively, compared with H pylori–negative individuals. When compared directly with H pylori–positive/untreated individuals, subdistribution hazard ratios for NCGA in H pylori–positive/treated were 0.95 (0.47–1.92) at <8 years and 0.37 (0.14–0.97) ≥8 years of follow-up. Compared with the Kaiser Permanente Northern California general population, standardized incidence ratios (95% confidence interval) of NCGA steadily decreased after H pylori treatment: 2.00 (1.79–2.24) ≥1 year, 1.01 (0.85–1.19) ≥4 years, 0.68 (0.54–0.85) ≥7 years, and 0.51 (0.38–0.68) ≥10 years.
In a large, diverse, community-based population, H pylori eradication therapy was associated with a significantly reduced incidence of NCGA after 8 years compared with no treatment. The risk among treated individuals became lower than the general population after 7 to 10 years of follow-up. The findings support the potential for substantial gastric cancer prevention in the United States through H pylori eradication.
[Display omitted]
Helicobacter pylori eradication therapy was associated with a significant reduction in the risk of developing noncardia gastric adenocarcinoma based on results from a large, diverse, community-based population. These findings support the potential for substantial gastric cancer prevention through testing and eradication of Helicobacter pylori in the United States.</description><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - epidemiology</subject><subject>Adenocarcinoma - prevention & control</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Eradication</subject><subject>Gastric Cancer</subject><subject>Helicobacter Infections - diagnosis</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter Infections - epidemiology</subject><subject>Helicobacter pylori</subject><subject>Humans</subject><subject>Incidence</subject><subject>Prevention</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - drug therapy</subject><subject>Stomach Neoplasms - epidemiology</subject><subject>Stomach Neoplasms - prevention & control</subject><subject>United States - epidemiology</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1q3DAUhUVpaaZp36AULbuxoz_b8qYQ0mkSGJpAk7XQSFeJBo_lSprAPEretjJOs8zqCumcc-_Vh9BXSmpKGn62qx90yjHUjDBeE1ET1r5DK9owWRFC2Xu0KqWtGiKbE_QppR0hpOeSfkQnvKOCMUJX6HntHJiMg8NXMHgTttpkiHg6DiF6vI7aeqOzDyO-e4SopyMux_wI-Ho03sJoYPb-DqPR0XqNL-ehvMHn5S2UO-PHsNfYj1jjjY4PgH_6J4gJ8G2YDsMS7ZfI-9FnsPhP1hnSZ_TB6SHBl5d6iu5_re8urqrNzeX1xfmmMoLIXDEuJbRt2ah3AogU4Jqua1jPetuzhmtmREes3nLJ3JZ2fUtbSR23shdNxxw_Rd-X3CmGvwdIWe19MjAMeoRwSIpJSnrGO8mLVCxSE0NKEZyaot_reFSUqBmK2qkFipqhKCJUgVJs3146HLZ7sK-m_xSK4McigLLnk4eokvHz11ofCxxlg3-7wz9RKaAU</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Li, Dan</creator><creator>Jiang, Sheng-Fang</creator><creator>Lei, Nan Ye</creator><creator>Shah, Shailja C.</creator><creator>Corley, Douglas A.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2691-5175</orcidid></search><sort><creationdate>202308</creationdate><title>Effect of Helicobacter pylori Eradication Therapy on the Incidence of Noncardia Gastric Adenocarcinoma in a Large Diverse Population in the United States</title><author>Li, Dan ; Jiang, Sheng-Fang ; Lei, Nan Ye ; Shah, Shailja C. ; Corley, Douglas A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-2388e663719f4e084ef57752929d9253a2c470dab382fb17961681f3d894572f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adenocarcinoma - drug therapy</topic><topic>Adenocarcinoma - epidemiology</topic><topic>Adenocarcinoma - prevention & control</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Eradication</topic><topic>Gastric Cancer</topic><topic>Helicobacter Infections - diagnosis</topic><topic>Helicobacter Infections - drug therapy</topic><topic>Helicobacter Infections - epidemiology</topic><topic>Helicobacter pylori</topic><topic>Humans</topic><topic>Incidence</topic><topic>Prevention</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - drug therapy</topic><topic>Stomach Neoplasms - epidemiology</topic><topic>Stomach Neoplasms - prevention & control</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Dan</creatorcontrib><creatorcontrib>Jiang, Sheng-Fang</creatorcontrib><creatorcontrib>Lei, Nan Ye</creatorcontrib><creatorcontrib>Shah, Shailja C.</creatorcontrib><creatorcontrib>Corley, Douglas A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Dan</au><au>Jiang, Sheng-Fang</au><au>Lei, Nan Ye</au><au>Shah, Shailja C.</au><au>Corley, Douglas A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Helicobacter pylori Eradication Therapy on the Incidence of Noncardia Gastric Adenocarcinoma in a Large Diverse Population in the United States</atitle><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle><addtitle>Gastroenterology</addtitle><date>2023-08</date><risdate>2023</risdate><volume>165</volume><issue>2</issue><spage>391</spage><epage>401.e2</epage><pages>391-401.e2</pages><issn>0016-5085</issn><eissn>1528-0012</eissn><abstract>High-quality data regarding the effect of Helicobacter pylori eradication on the risk of noncardia gastric adenocarcinoma (NCGA) remain limited in the United States. We investigated the incidence of NCGA after H pylori eradication therapy in a large, community-based US population.
We performed a retrospective cohort study of Kaiser Permanente Northern California members who underwent testing and/or treatment for H pylori between 1997 and 2015 and were followed through December 31, 2018. The risk of NCGA was evaluated using the Fine-Gray subdistribution hazard model and standardized incidence ratios.
Among 716,567 individuals with a history of H pylori testing and/or treatment, the adjusted subdistribution hazard ratios and 95% confidence intervals of NCGA for H pylori–positive/untreated and H pylori–positive/treated individuals were 6.07 (4.20–8.76) and 2.68 (1.86–3.86), respectively, compared with H pylori–negative individuals. When compared directly with H pylori–positive/untreated individuals, subdistribution hazard ratios for NCGA in H pylori–positive/treated were 0.95 (0.47–1.92) at <8 years and 0.37 (0.14–0.97) ≥8 years of follow-up. Compared with the Kaiser Permanente Northern California general population, standardized incidence ratios (95% confidence interval) of NCGA steadily decreased after H pylori treatment: 2.00 (1.79–2.24) ≥1 year, 1.01 (0.85–1.19) ≥4 years, 0.68 (0.54–0.85) ≥7 years, and 0.51 (0.38–0.68) ≥10 years.
In a large, diverse, community-based population, H pylori eradication therapy was associated with a significantly reduced incidence of NCGA after 8 years compared with no treatment. The risk among treated individuals became lower than the general population after 7 to 10 years of follow-up. The findings support the potential for substantial gastric cancer prevention in the United States through H pylori eradication.
[Display omitted]
Helicobacter pylori eradication therapy was associated with a significant reduction in the risk of developing noncardia gastric adenocarcinoma based on results from a large, diverse, community-based population. These findings support the potential for substantial gastric cancer prevention through testing and eradication of Helicobacter pylori in the United States.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37142201</pmid><doi>10.1053/j.gastro.2023.04.026</doi><orcidid>https://orcid.org/0000-0002-2691-5175</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0016-5085 |
| ispartof | Gastroenterology (New York, N.Y. 1943), 2023-08, Vol.165 (2), p.391-401.e2 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); Alma/SFX Local Collection |
| subjects | Adenocarcinoma - drug therapy Adenocarcinoma - epidemiology Adenocarcinoma - prevention & control Anti-Bacterial Agents - therapeutic use Eradication Gastric Cancer Helicobacter Infections - diagnosis Helicobacter Infections - drug therapy Helicobacter Infections - epidemiology Helicobacter pylori Humans Incidence Prevention Retrospective Studies Stomach Neoplasms - drug therapy Stomach Neoplasms - epidemiology Stomach Neoplasms - prevention & control United States - epidemiology |
| title | Effect of Helicobacter pylori Eradication Therapy on the Incidence of Noncardia Gastric Adenocarcinoma in a Large Diverse Population in the United States |
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