ULCER BUG INCREASES RISK OF STOMACH CANCER 

Evidence is mounting that the ulcer bacterium, H. pylori, increases the risk of the world's second most deadly malignancy, stomach cancer.

Speaking at the recent European Cancer Conference in Lisbon, Professor David Forman from the University of Leeds said that there is now "persuasive evidence" from several studies linking Helicobacter pylori infection to stomach cancer.

Collectively, these studies show that there is a three- to six-fold increased risk of non-cardia stomach cancer in people who test positive for H. pylori, he said. Non-cardia cancer represents all regions of the stomach except for the uppermost portion.

The findings suggest there may be a case for universal screening for the bacterium to lower rates of the disease, Professor Forman argued.

"Apart from smoking, very few established causes of cancer have been associated with an attributable risk of this magnitude," he said.

"At least half of all non-cardia cancer can be attributable to the infection and possibly a great deal more."

Screening for H. pylori may enable earlier identification of people at risk of stomach cancer, which accounts for one million deaths worldwide each year, said Professor Forman. Fatalities are largely attributed to diagnoses made at an advanced stage of the disease.

In theory, eradication of the bacterium with a course of antibiotics may then lower death rates, though it remains to be proven whether eradication would actually slow or prevent any cancerous changes already begun.

"Much remains to be established about the relationship [between H. pylori and stomach cancer]," he explained, "in particular the reason why certain populations or patient groups have relatively low gastric cancer rates despite high levels of infection".

"The case for population based intervention, balancing out risks and benefits, still has to be made."

However, the advantage of controlling H. pylori is that it is likely to be easier than controlling other risk factors for cancer — such as smoking, diet, and sunlight exposure, said Professor Forman.

It would also be cheaper than other screening technologies, such as mammography and pap smears, he said.

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