The Value of Helicobacter Eradication in Long-term Aspirin Users
Menée à Hong Kong à partir de données portant sur 63 605 patients ayant reçu entre 2003 et 2012 une trithérapie à base de clarithromycine pour éradiquer la bactérie Helicobacter pylori (durée médiane de suivi : 7,6 ans), cette étude évalue l'association entre l'utilisation d'aspirine après la trithérapie et le risque de cancer de l'estomac
In this issue, Cheung et al. (1) report a surprisingly large preventive effect of aspirin on gastric cancer in individuals who have been successfully treated for Helicobacter pylori. Most of the more than 50 randomized trials and 100 epidemiologic studies examining the impact of aspirin use on gastric cancer reported a reduction of 30% to 35% in incidence and mortality among long-term users, with little impact in the first three to five years of use (2–5). However, most of these studies have not examined the effect of aspirin according to H. pylori status, and the ones that have (6–8) do not clearly separate those where the infection was successfully treated from those where it was not. The current report only considers those who were H. pylori positive but in whom the infection was successfully treated, and it suggests that aspirin use has led to a 70% (95% confidence interval [CI] = 39% to 85%) reduction in gastric cancer in this group.