Abstract CN01-03: Opportunities in reducing stomach cancers associated with H. pylori

Gastric cancer is one of the most common cancers in the world and a leading cause of cancer deaths worldwide. Helicobacter pylori infection of the gastric mucosa is estimated to be responsible for causing more than half of all gastric adenocarcinomas. Gastric cancer occurs more frequently in African Americans than in Caucasians. The death rates from gastric cancer in African Americans are more than twice that of Caucasians with this disease. Epidemiology of Gastric cancer is similar to that of H. pylori in that both occur more frequently in minority populations and in low income areas throughout the world. Reactive oxygen species are important in the development of gastric cancer in the presence and absence of H. pylori infection. Thus nutrition and the intake of antioxidants may help to protect people from developing gastric cancer. Treating H. pylori infection in younger adults has been shown to reduce the risk of developing gastric cancer in high incidence areas. Currently treatment includes two antibiotics, plus a proton pump inhibiter to reduce gastric acid secretion. Recently progress made in the development of a vaccine against H. pylori. An intramuscular H. pylori vaccine has been tested in uninfected healthy volunteers and was found to be safe and produced antigen specific T-cell memory. Preventing and/or treating H. pylori infection can go a long way in reducing the incidence of Gastric cancer. Thus there is a significant opportunity to reduce gastric cancer in African Americans, primarily through early treatment of this infection. However, improving nutrition is another way by which the same objective may be reached. Wide spread treatment of asymptomatic patients will lead to some morbidity and therefore should not be taken lightly. Wide spread treatment of the population will be associated with an increase in antibiotic resistance, making it difficult to easily treat everyone who is infected. Many people will need to receive a second course of therapy and thus more likely to develop side effects. Further research into a vaccine along with development of better antibiotics will greatly assist in reducing this health disparity.