Original ResearchFull Report: Helicobacter pyloriEffect of Helicobacter pylori Eradication on Gastric Cancer Prevention: Updated Report From a Randomized Controlled Trial With 26.5 Years of Follow-up
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Study Participants and Study Design
This is an updated report of a randomized, placebo-controlled trial conducted in Changle of Fuzhou, Fujian Province, China, in July 1994, with an extended follow-up time up to 26.5 years. Details of the study design, including eligibility criteria, number of enrolled participants, treatment arms, and results of 7.5-year follow-up of this trial have been published previously.16 Briefly, a total of 2423 eligible healthy participants aged 35–65 years were recruited from 7 local villages and each
Results
During a maximum follow-up duration of 26.5 years, a total of 56 cases of gastric cancer were diagnosed. Table 1 shows the crude incidence rates of gastric cancer by baseline participant characteristics. Statistically significant differences were noted between groups by age, sex, daily smoking status, green tea consumption frequency, and histopathology findings.
Discussion
In this prospective, randomized, placebo-controlled trial, a significant protective effect of H pylori eradication on the risk of gastric cancer was found, and the effects were consistent by tumor subsite (cardia vs noncardia) or by follow-up duration. However, the favorable effects were only evident among those without precancerous gastric lesions and those without dyspepsia symptoms at baseline. The most significant risk reduction was noted among participants with successful eradication as
Acknowledgments
The authors thank the residents for participating in the trial; the administrative staff Zuxia Zhang, Lici Chen from Changle Center for Disease Prevention and Control, for the assistance with the study during the trial period; the gastroenterologists Fenglin Chen and Hao Chen, and nurses Mingtan Hou and Qingqing Zu from the Affiliated Union Hospital of Fujian Medical University for their assistance in gastroscopic examination in this study.
CRediT Authorship Contributions
Lingjun Yan, PhD (Conceptualization: Equal; Formal
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Conflicts of interest The authors disclose no conflicts.
Funding This study was supported by High-Level Talents Research Start-Up Project of Fujian Medical University, China (XRCZX2017035 and XRCZX2020034); Technology Development Fund from Fujian Province, China (2019L3006). The funding sponsor was not involved in the study design or in the collection, analysis, and interpretation of data.
Author names in bold designate shared co-first authorship.
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Authors share co-first authorship.