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World J Gastroenterol. Jun 7, 2007; 13(21): 2901-2912
Published online Jun 7, 2007. doi: 10.3748/wjg.v13.i21.2901
Diet, H pylori infection and gastric cancer: Evidence and controversies
Alba Rocco, Gerardo Nardone
Alba Rocco, Gerardo Nardone, Department of Clinical and Experimental Medicine, Gastroenterology Unit, University “Federico II”, Naples, Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Gerardo Nardone, MD, Dipartimento di Medicina Clinica e Sperimentale, Unità di Gastroenterologia, Università degli Studi di Napoli “Federico II”, Via Pansini n° 5, Napoli 80131, Italy.
Telephone: +39-81-7464293 Fax: +39-81-7464293
Received: December 1, 2006
Revised: December 15, 2006
Accepted: December 20, 2006
Published online: June 7, 2007

Despite decreasing incidence and mortality rates, gastric cancer (GC) still remains the fourth most common cancer and the second most common cause of cancer-related deaths worldwide. Due to the limited treatment options, at present, prevention is likely to be the only effective means of controlling this disease. The success of a prevention strategy depends upon the understanding of etiological and pathogenic mechanisms underlying gastric carcinogenesis. The etiology of GC is multi-factorial, however, in the recent years, mounting evidence suggests that environmental factors play a key role. The most important environmental factors implicated in the pathogenesis of GC are diet and H pylori infection. Thus, modifications in lifestyle and dietary habit associated with eradication of H pylori infection could hypothetically represent the most promising potential targets for GC prevention. In this review we will address the evidence and the controversies on the role of these agents in non-cardia GC by focusing on retrospective and prospective observational studies and interventional trials.

Keywords: Gastric cancer, H pylori, Diet, Observational studies, Interventional dietary trials