Testing for Helicobacter and Precancerous Conditions May Help Head Off Malignancy in Relatives of Persons with Stomach Cancer


Testing for Helicobacter and Precancerous Conditions May Help Head Off Malignancy in Relatives of Persons with Stomach Cancer

First-degree relatives of persons who have had stomach cancer are at an increased risk to develop the disease themselves. For this reason, researchers are now recommending testing for

Helicobacter pylori, low acid production, and shrinkage and loss of cells in the stomach, 3 factors that are associated with an increased risk for developing this type of cancer.

Cancer of the stomach (or gastric cancer) is characterized by the presence of cancer cells in the tissues of the stomach, which is located in the upper abdomen. It is known that first-degree relatives (parents, siblings, children) of persons who have had stomach cancer are at an increased risk for the disease themselves; however, it is not understood whether this increased risk is the result of genetics or a shared environment. Researchers continue to work toward determining which factors contribute to the development of stomach cancer so that better strategies for prevention, early detection, and treatment can be designed and implemented. A person who has 1 or more characteristics or exposures, or risk factors, for a type of cancer has a higher chance to develop that type of cancer than a person who does not have these risk factors.

The primary risk factor that has been noted for stomach cancer thus far is the presence of the

bacteria Helicobacter pylori (H pylori) in the stomach. Infection with

H pylori causes a reduction in the normal acid production and a shrinkage and loss of cells (called

atrophy) in the stomach. Atrophy of the stomach, in particular, is considered to be a precancerous condition. Often treatment with antiobiotics can lead to resolution of the

H pylori infection, low acid production, and atrophy. Recently, 2 separate groups of researchers screened (tested) first-degree relatives of persons with stomach cancer to determine whether they indeed had a higher than usual incidence of these 3 factors.

Researchers in Scotland screened 100 first-degree relatives of persons who had stomach cancer for the presence of

H pylori, low acid production, and atrophy of the stomach. The results were compared with those from a control group, consisting of 50 spouses of persons with stomach cancer. The findings showed that 27% of the relatives had low stomach acid production, compared with only 3% of controls. The incidence of stomach atrophy in the relatives was 34%, compared with 5% in controls. Among the relatives group, increased incidences of low acid production and atrophy were present only in those who also had

H pylori infection. Treatment of the H pylori infection with antibiotics led to a resolution of any inflammation as well as of low acid production and atrophy in 50% of persons. These researchers concluded that the first-degree relatives did, in fact, have an increased incidence of precancerous abnormalities of the stomach in association with

H pylori infection. They advised screening and treatment of these individuals in an effort to resolve the infection before it progresses to cancer.*

In a similar study, researchers from Germany evaluated 1351 men and women, ages 30 to 74 years, for the presence of

H pylori. These investigators found that 69% of persons whose parent had stomach cancer and 44% whose other relatives had stomach cancer did indeed have

H pylori infection. This association was greatest in persons 55 years of age and younger. These results suggest that the increased risk for relatives of those with stomach cancer may be explained, in part, by a shared increased incidence of

H pylori infection among these family members.**

*(Gastroenterology, Volume 118, No 1, pp 22-30, 2000)

**(Gastroenterology, Volume 118, No 1, pp 31-35, 2000)

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