Risk of Gastric cancer from PPIs?

The various unpleasant manifestations of Helicobacter can be described here. Remember however that the great majority of persons with Hp have no symptoms that they are aware of and consider themselves normal.

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redheadj
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Risk of Gastric cancer from PPIs?

Post by redheadj » Thu Jun 27, 2019 6:46 am

Hey, found this study from Hong Kong about the use of PPIs on patients diagnosed with HP and the increased chance of developing GC. Is this true? Rather worried and thinking of stopping my PPIs

https://gut.bmj.com/content/67/1/28

Helico_expert
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Re: Risk of Gastric cancer from PPIs?

Post by Helico_expert » Thu Jun 27, 2019 9:59 am

The title is a bit misleading.

If you read the data carefully, you can see that people without H pylori, there is little gastric cancer from patients who take long term PPI.

For patients with H pylori infection, the gastric cancer rate is already higher than those that are not infected. So this study basically showed that even eradicate of H pylori, there is still risk of Gastric cancer.
E9C92128-4E22-42DA-B4BA-F6029E680841.jpeg

ankiwo72
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Re: Risk of Gastric cancer from PPIs?

Post by ankiwo72 » Fri Sep 13, 2019 4:40 am

Helico_expert wrote:
Thu Jun 27, 2019 9:59 am
The title is a bit misleading.

If you read the data carefully, you can see that people without H pylori, there is little gastric cancer from patients who take long term PPI.

For patients with H pylori infection, the gastric cancer rate is already higher than those that are not infected. So this study basically showed that even eradicate of H pylori, there is still risk of Gastric cancer.

E9C92128-4E22-42DA-B4BA-F6029E680841.jpeg
Are these patients showing that the H.Pylori was eradicated or just that there was treatment?

I am concerned that if I fail to eradicate HP that I have a risk to develop GC. However, my husband thinks the concern is overblown. He asked me:

1) Out of all people with GC, what % of them are caused by HP?
2) Out of all people with HP, what % get GC?

I could not find any information that relates to my situation. I don't know when I got HP (here in US or in Korea) and if the strain type matters. I was raised by western family since I was a toddler but was in Korea for the first year of life.

Typically how fast/slow does HP Chronic Gastritis progress to malignancy without treatment?

Thanks!

Helico_expert
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Re: Risk of Gastric cancer from PPIs?

Post by Helico_expert » Fri Sep 13, 2019 11:38 am

the factors that causes cancer include
1. your genetics
2. your diet
3. H. pylori

not all H. pylori causes gastric cancer. There are many types of H. pylori out there. It seems like the Asian strain is extremely carcinogenic. 50% of the world's gastric cancer is in China, Japan, Korea, and Mongolia.

almost all gastric cancer is due to H. pylori. In Australia, the prevalence of H. pylori is so low, gastric cancer is almost eradicated.

when you are infected with H. pylori, your gastric cancer risk increase tiny bit every year. while 80% of the carrier will be asymptomatic, about 1% of the will develop gastric cancer.

If you are young, eradication of H. pylori can reduce gastric cancer risk.
This is a rough estimate of your gastric cancer risk score
above 40 and has HP +1 (+2 if over 50)
has genetic background +2
Live in Asia country +1
Smoking +1
has Intestinal metaplasia +1 (+2 if mild; +3 if severe)
has atrophic gastritis +1 (+2 if mild; +3 if severe)
has peptic ulcer -2 (people with stomach ulcer rarely get stomach cancer)

the higher the score, the higher the risk.

Maria.b
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Re: Risk of Gastric cancer from PPIs?

Post by Maria.b » Fri Sep 13, 2019 3:48 pm

This is very interesting and informative but must admit has really scared me im 46 yrs with intestinal metaplasia via h pylori 1 half yrs ago and gastritis dont know how bad either are as just noted i have both. Live in cyprus and i admit i smoke very light but i do and h pylori seems very common in cyprus and no ulcers what are my chances?

ankiwo72
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Re: Risk of Gastric cancer from PPIs?

Post by ankiwo72 » Sat Sep 14, 2019 12:36 am

Helico_expert wrote:
Fri Sep 13, 2019 11:38 am
the factors that causes cancer include
1. your genetics
2. your diet
3. H. pylori

not all H. pylori causes gastric cancer. There are many types of H. pylori out there. It seems like the Asian strain is extremely carcinogenic. 50% of the world's gastric cancer is in China, Japan, Korea, and Mongolia.

almost all gastric cancer is due to H. pylori. In Australia, the prevalence of H. pylori is so low, gastric cancer is almost eradicated.

when you are infected with H. pylori, your gastric cancer risk increase tiny bit every year. while 80% of the carrier will be asymptomatic, about 1% of the will develop gastric cancer.

If you are young, eradication of H. pylori can reduce gastric cancer risk.
This is a rough estimate of your gastric cancer risk score
above 40 and has HP +1 (+2 if over 50)
has genetic background +2
Live in Asia country +1
Smoking +1
has Intestinal metaplasia +1 (+2 if mild; +3 if severe)
has atrophic gastritis +1 (+2 if mild; +3 if severe)
has peptic ulcer -2 (people with stomach ulcer rarely get stomach cancer)

the higher the score, the higher the risk.
Thank you.

Can you please clarify, that the +/- points are they related to percentages?
I was born in Korea but came to US as child (age 14mos old) in 1973, raised by Western family on Western diet (but we did use a lot of salt). I have no idea how long I have had HPylori. I was in orphanage and foster home in Korea until adoption, and have no knowledge of genetic risk factor - should I automatically assume I have genetic higher risk? Would I be more at Western/US-risk or Korea-risk as far as the strain I carry and cannot seem to eradicate?

It's times like these that being adopted really stinks.

Helico_expert
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Re: Risk of Gastric cancer from PPIs?

Post by Helico_expert » Sat Sep 14, 2019 5:04 pm

I just develop the scoring system based on what I know. there is no publication and so it cannot be translated to percentage.

You most probably got the asian strain when you are young.

but most importantly is the endoscopy and histology report. Gastric cancer doesnt happen over night. It will take years to develop. If it really bothers you, you can do a yearly endoscopy to reduce the risk.

ankiwo72
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Re: Risk of Gastric cancer from PPIs?

Post by ankiwo72 » Wed Sep 18, 2019 10:52 am

Helico_expert wrote:
Sat Sep 14, 2019 5:04 pm
I just develop the scoring system based on what I know. there is no publication and so it cannot be translated to percentage.

You most probably got the asian strain when you are young.

but most importantly is the endoscopy and histology report. Gastric cancer doesnt happen over night. It will take years to develop. If it really bothers you, you can do a yearly endoscopy to reduce the risk.
Even with higher risk factors, the chance of developing gastric cancer is still quite low, isn’t it? Even for people who have the bacteria but never successfully eradicate it?

Helico_expert
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Re: Risk of Gastric cancer from PPIs?

Post by Helico_expert » Wed Sep 18, 2019 12:45 pm

Yes. Even with high score, the chance of developing cancer is still very low. Maybe 1 among 100 people in the high risk group.

So, people in the high risk group should do annual endoscopy check to prevent gastric cancer.

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