Increased prevalence of precancerous changes in relatives of gastric cancer patients: Critical role of H-pylori

Background & Aims: Helicobacter pylori is believed to predispose to gastric cancer by inducing gastric atrophy and hypochlorhydria, First-degree relat ives of patients with gastric cancer have an increased risk of developing g astric cancer, The aim of this study was to determine the prevalence of atr ophy and hypochlorhydria and their association with H. pylori infection in first-degree relatives of patients with gastric cancer. Methods: H. pylori status, gastric secretory function, and gastric histology were studied in 1 00 first-degree relatives of patients with noncardia gastric cancer and com pared with those of controls with no family history of this cancer, Results : Compared with healthy controls, relatives of patients with gastric cancer had a higher prevalence of hypochlorhydria (27% vs. 3%) but a similar prev alence of H. pylori infection (63% vs, 64%), Relatives of cancer patients a lso had a higher prevalence of atrophy (34%) than patients with nonulcer dy spepsia (5%) matched for H. pylori prevalence. Among the relatives of cance r patients, the prevalence of atrophy and hypochlorhydria was increased onl y in those with evidence of H. pylori infection, was greater in relatives o f patients with familiar cancer than in relatives of sporadic cancer index patients, and increased with age. Eradication of H. pylori infection produc ed resolution of the gastric inflammation in each subject and resolution of hypochlorhydria and atrophy in 50% of the subjects, Conclusions: Relatives of patients with gastric cancer have an increased prevalence of precancero us gastric abnormalities, but this increase is confined to those with H. py lori infection. Consequently, prophylactic eradication of the infection sho uld be offered to such subjects.