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More randomised trial evidence on the role of Helicobacter pylori eradication in preventing gastric cancer ▸

There is persuasive epidemiological evidence implicating Helicobacter pylori as the main cause of non-cardia gastric cancer. There have been randomized controlled trials in China (

) and Colombia (Mera R, et al. Gut 2005;54:1536–40) but these have not had sufficient power to reach definitive conclusions. You et al report a randomised controlled trial of H pylori eradication, vitamin supplementation, and/or garlic in 3365 subjects aged 35–64 years from the Shandong Province in China. Subjects were given a baseline endoscopy and randomised to receive omeprazole 20 mg and amoxicillin 1 g both twice daily for two weeks (in 2258 infected cases), a vitamin capsule containing vitamin C (250 mg), vitamin E (100 IU), and selenium (37.5 μg), a garlic capsule, or placebo in a 2×2×2 factorial design. H pylori eradication was achieved in 62% of the active treatment group and subjects were followed up for a mean of 7.3 years with repeat endoscopies in 1999 and 2003. H pylori eradication therapy resulted in a significant decrease in the combined end point of severe chronic atrophic gastritis, intestinal metaplasia, dysplasia, or gastric cancer (odds ratio 0.77 (95% confidence interval 0.62–0.95)). Fewer subjects allocated to H …

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