Potent Tool: Helicobacter pylori Treatment to Reduce the Risk of Both Gastric and Colorectal Cancers
Menée aux Etats-Unis auprès de 812 736 vétérans (durée de suivi : 15 ans), cette étude analyse l'effet d'une infection par Helicobacter pilori et du traitement de cette infection sur l'incidence du cancer colorectal et la mortalité spécifique
For decades there has been a heated yet still unresolved debate on the benefits and harms of eradication treatment for H. pylori, a common bacterium that causes gastric cancer in a small percentage of those chronically infected, trying to decipher whether to test and treat for H. pylori infection among individuals without gastric distress. Arguments against this approach highlight the potential negative consequences of a 2-week antibiotic treatment, including side effects that can lead to nonadherence of the full course of treatment, increasing antibiotic resistance, the possible impact of decreasing diversity of the microbiome, and, notably, removal of the hypothesized benefits, such as immune modulation and reduced acid secretion, of this ancient bacterium that has evolved to live in the stomachs of humans over hundreds of thousands of years. Those in favor of the H. pylori test-and-treat strategy argue that H. pylori therapy is a simple and cost-effective intervention that resolves stomach distress, gastritis, and ulcers and, most importantly, halves the risk of developing gastric adenocarcinoma, a rare but highly fatal malignancy. Additionally, positive associations between H. pylori infection and colorectal cancer incidence have been observed,1 suggesting that H. pylori test-and-treat strategy could even provide a buy one get one free possibility, with eradication therapy not only reducing stomach cancer risk and mortality but also reducing risk of colorectal cancer, the third most common cancer worldwide.
Journal of Clinical Oncology , éditorial en libre accès, 2023