The Value of Helicobacter Eradication in Long-term Aspirin Users

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.

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