0
0
A groundbreaking study from Taiwan has evaluated the potential of a dual fecal screening test to detect stomach cancer caused by Helicobacter pylori (H. pylori), a bacterium carried by nearly half of the global population. The research, led by Dr. Yi-Chia Lee and his team at the National Taiwan University College of Medicine, sought to determine if early screening could reduce cancer incidence and mortality. Despite encouraging hopes, the findings were mixed.
Stomach cancer, known as gastric cancer, remains one of the leading causes of cancer-related death worldwide, especially in Asia. While H. pylori infection is a known risk factor for stomach cancer, not everyone infected with the bacterium develops the disease. In fact, H. pylori is found in roughly 50% of people globally, but most carry it without complications.
In the 1980s, Australian scientists Dr. Barry Marshall and Dr. Robin Warren discovered that H. pylori, a corkscrew-shaped bacterium, was the primary cause of stomach ulcers. Their discovery led to an overnight treatment revolution, where antibiotics became the standard cure for peptic ulcers. Their work earned them the Nobel Prize in Medicine in 2005, and since then, H. pylori has been further linked to gastric cancer and lymphoma.
In the new study, researchers tested the efficacy of screening for H. pylori using a fecal antigen test, known as HPSA, combined with a fecal immunochemical test (FIT). FIT is commonly used to screen for colon cancer by detecting occult blood in stool samples. However, researchers hypothesized that combining FIT with the HPSA test, which detects H. pylori infection, might improve early detection of gastric cancer, which is linked to the chronic inflammation caused by the bacteria.
The study was conducted over several years, with 152,503 residents of Taiwan invited to participate. Participants, aged 50 to 69, were divided into two groups: one screened with both HPSA and FIT, and the other with FIT alone. The study aimed to assess whether the combined screening method could lower the incidence and mortality of gastric cancer.
Although H. pylori is a known Class 1 carcinogen—meaning it has sufficient evidence of causing cancer—the results of the study were inconclusive. Researchers observed a slightly lower incidence of gastric cancer in the group screened with both tests (0.032%) compared to the FIT-only group (0.037%). However, the difference was minimal, and when accounting for variations in participation rates and follow-up times, the researchers found no significant reduction in cancer mortality between the two groups.
Dr. Lee and his colleagues concluded that while screening with both HPSA and FIT did not significantly improve outcomes, there was a slight reduction in cancer incidence in the combined screening group. The results suggest that screening for H. pylori infection, while useful, may not be a definitive solution to reducing gastric cancer risk on a large scale.
The study raises important questions about the role of early screening in preventing gastric cancer. Although antibiotics have proven effective in eradicating H. pylori, it remains unclear whether community-wide screening and treatment will significantly impact cancer rates.
With over 800,000 new cases of gastric cancer annually, H. pylori-related adenocarcinoma is the third leading cause of cancer globally, according to the World Health Organization (WHO). In Taiwan, Japan, and other parts of Asia, stomach cancer remains a major public health concern. Despite the study’s mixed results, the research continues to highlight the need for effective screening and treatment strategies to combat this deadly disease.
For more details, refer to the study published in the Journal of the American Medical Association (JAMA).
