Increased prevalence of precancerous changes in relatives of gastric cancer patients: critical role of H. pylori.

Abstract:

BACKGROUND & AIMS:Helicobacter pylori is believed to predispose to gastric cancer by inducing gastric atrophy and hypochlorhydria. First-degree relatives of patients with gastric cancer have an increased risk of developing gastric cancer. The aim of this study was to determine the prevalence of atrophy and hypochlorhydria and their association with H. pylori infection in first-degree relatives of patients with gastric cancer. METHODS:H. pylori status, gastric secretory function, and gastric histology were studied in 100 first-degree relatives of patients with noncardia gastric cancer and compared with those of controls with no family history of this cancer. RESULTS:Compared with healthy controls, relatives of patients with gastric cancer had a higher prevalence of hypochlorhydria (27% vs. 3%) but a similar prevalence of H. pylori infection (63% vs. 64%). Relatives of cancer patients also had a higher prevalence of atrophy (34%) than patients with nonulcer dyspepsia (5%) matched for H. pylori prevalence. Among the relatives of cancer patients, the prevalence of atrophy and hypochlorhydria was increased only in those with evidence of H. pylori infection, was greater in relatives of patients with familial cancer than in relatives of sporadic cancer index patients, and increased with age. Eradication of H. pylori infection produced resolution of the gastric inflammation in each subject and resolution of hypochlorhydria and atrophy in 50% of the subjects. CONCLUSIONS:Relatives of patients with gastric cancer have an increased prevalence of precancerous gastric abnormalities, but this increase is confined to those with H. pylori infection. Consequently, prophylactic eradication of the infection should be offered to such subjects.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

El-Omar EM,Oien K,Murray LS,El-Nujumi A,Wirz A,Gillen D,Williams C,Fullarton G,McColl KE

doi

10.1016/s0016-5085(00)70410-0

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

22-30

issue

1

eissn

0016-5085

issn

1528-0012

pii

S0016508500390151

journal_volume

118

pub_type

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