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World J Gastroenterol. Aug 28, 2006; 12(32): 5101-5107
Published online Aug 28, 2006. doi: 10.3748/wjg.v12.i32.5101
Eradication of H pylori for the prevention of gastric cancer
Karolin Trautmann, Manfred Stolte, Stephan Miehlke
Karolin Trautmann, Stephan Miehlke, Medical Department I, Technical University Hospital Carl Gustav Carus, Dresden, Germany
Manfred Stolte, Institute for Pathology, Klinikum Bayreuth, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Stephan Miehlke, Professor, Medical Department I, Technical University Hospital, Fetscherstr. 74, Dresden 01307, Germany. stephan.miehlke@uniklinikum-dresden.de
Telephone: +49-351-4585645 Fax: +49-351-4585859
Received: December 2, 2005
Revised: January 8, 2006
Accepted: January 14, 2006
Published online: August 28, 2006

Infection with H pylori is the most important known etiological factor associated with gastric cancer. While colonization of the gastric mucosa with H pylori results in active and chronic gastritis in virtually all individuals infected, the likelihood of developing gastric cancer depends on environmental, bacterial virulence and host specific factors. The majority of all gastric cancer cases are attributable to H pylori infection and therefore theoretically preventable. There is evidence from animal models that eradication of H pylori at an early time point can prevent gastric cancer development. However, randomized clinical trials exploring the prophylactic effect of H pylori eradication on the incidence of gastric cancer in humans remain sparse and have yielded conflicting results. Better markers for the identification of patients at risk for H pylori induced gastric malignancy are needed to allow the development of a more efficient public eradication strategy. Meanwhile, screening and treatment of H pylori in first-degree relatives of gastric cancer patients as well as certain high-risk populations might be beneficial.

Keywords: Gastric cancer, H pylori, Eradication