Original ResearchFull Report: Clinical—Alimentary TractEffects of Helicobacter pylori Treatment on Incidence of Gastric Cancer in Older Individuals
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Study Design and Data Source
We identified subjects who had received a course of clarithromycin-containing triple therapy for H pylori infection between January 2003 and December 2012 in all public hospitals managed by the Hospital Authority in Hong Kong.13 The Hospital Authority is the sole public health service provider, serving a local population of 7.3 million under a heavily subsidized public health care system.14 It manages 87% of all hospital beds in Hong Kong and has more than 7.5 million outpatient specialist
Gastric Cancer Risk in the H pylori–Treated Cohorts
A total of 73,237 patients had received a course of clarithromycin-containing triple therapy for H pylori during the study period. The baseline characteristics of these patients are shown in Table 1. Among them, 9,840 (13.4%) patients needed retreatment for H pylori, including 130 patients who needed third-line therapy. The median duration from the time of prescription of clarithromycin-containing triple therapy to the second-line and third-line therapy was 1.5 years (interquartile range [IQR],
Discussion
The results from this territory-wide study from Hong Kong provide strong support that H pylori treatment, even when given to those 60 years or older, who are the highest-risk group, could still lower the risk of gastric cancer development. When compared with a matched general population, which comprises both H pylori–infected and noninfected individuals, the risk of gastric cancer was reduced by 18% in the older (≥60 years) age group who had received H pylori treatment. When further stratified
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Cited by (0)
Author contributions Wai K. Leung was responsible for the conception and design of this study, data interpretation, and drafting of the manuscript. Esther W. Chan, Angel Y.S. Wong, and Lijia J. Chen were involved in data collection. Irene O.L. Wong, Ka Shing Cheung, and Kar Fu Yeung were involved in data analysis, data interpretation, and drafting of the manuscript. Ian C.K. Wong and David Y. Graham were responsible for data interpretation and critical review of the manuscript.
Conflicts of interest The authors disclose no conflicts.
Funding Wai K. Leung has received honoraria for attending advisory board meetings of Takeda and Abbot Laboratories.
Author names in bold designate shared co-first authorship.