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Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g3174 (Published 20 May 2014) Cite this as: BMJ 2014;348:g3174

Re: Helicobacter pylori eradication therapy to prevent gastric cancer in healthy asymptomatic infected individuals: systematic review and meta-analysis of randomised controlled trials

I read with interest the metanalysis on Helicobacter pylori (Hp) erradication to prevent gastric cancer and found the results intriguing.

I wonder whether the time of follow up, around 5 years (just two studies have more than 10 years) is enough to consider Hp erradication as the most important preventive factor as most studies find Hp in children and cancer develops usually after more than three decades.

Another interesting issue is that there was no difference with the presence of pre-neoplastic lesions and stomach cancer, one will have expected less cancer in patients withouth these lesions. The cascade proposed several years ago remains unproven.

Finally it remains unclear whether we should have a program of erradication of Hp in order to prevent gastric cancer.

Competing interests: No competing interests

28 May 2014
Alejandro Piscoya
Gastroenterologist
Universidad Peruana de Ciencias Aplicadas
Maestro Barbieri 182, Lima 41 - Peru