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Helicobacter pylori May Help Lower Risk for Oesophageal Cancer: Presented at DDW

By Mike Fillon

ORLANDO, FL-- May 23, 2003 -- Patients carrying the Helicobacter pylori bacterium (HP) have a 70% lower risk for oesophageal cancer than those not carrying H.Pylori, a cause of stomach ulcers, according to a prospective study.

Adenocarcinoma of the oesophagus - a type of cancer that now comprises nearly half of all new oesophageal tumours - is rapidly increasing in frequency in North America and Europe.

The study reviewed data from oesophageal adenocarcinoma cases occurring in more than 125,000 people who participated in a multiphasic health check-up between 1964 and 1969. "The protective association appears to be quite strong and consistent across a number of comparison groups," said lead researcher Catherine de Martel, MD, at the Stanford University School of Medicine in Stanford CA. "It's really quite remarkable."

The results were presented here at Digestive Disease Week (DDW) and the 104^th Annual Meeting of the American Gastroenterological Association.

Fifty two patients with adenocarcinoma of the oesophagus were compared to several control groups without cancer. Stored serum samples collected at enrolment were tested for lgG antibodies against HP and for lgG antibodies against the CagA gene product of HP. Even when controlled for cigarette use, body mass, alcohol consumption, race and education, subjects infected with HP were significantly less likely than uninfected subjects to develop oesophageal cancer in an average 19.2-year follow-up period. Data on CagaA antibodies are still being analysed.

Dr. de Martel pointed out that previously published studies have suggested people with HP infection have less heartburn -- gastroesophageal reflux disease of GERD -- than did people without infection. The authors have speculated this is because the stomachs of some HP-infected people have reduced acid-secreting capacity. Since oesophageal damage caused by GERD increases risk for adenocarcinoma, Dr. de Martel speculates that reduction in GERD may be the mechanism by which HP protects against oesophageal adenocarcinoma.

"What this means for individual patients is not clear," said Dr. de Martel. "There are many adverse consequences to H.pylori infection and there are always many other factors involved in the genesis of cancer. There's a lot of work left to do before we know how HP and these other factors balance out."


[Study title: Helicobacter pylori Infection and Subsequent Adenocarcinoma of the Esophagus. Abstract 500002]

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