By Reuters Staff
NEW YORK (Reuters Health) - 8/8/2019
Diabetes appears to increase the risk of gastric cancer after Helicobacter pylori eradication, especially in patients with suboptimal glycemic control, according to a database study.
H. pylori infection increases the risk of gastric cancer at least threefold, and some (but not all) studies have found an increased risk of gastric cancer in people with diabetes.
Dr. Wai K. Leung of The University of Hong Kong and colleagues used data from the Clinical Data Analysis and Reporting System of the Hong Kong Hospital Authority to investigate the possible association between type 2 diabetes and gastric cancer among more than 46,000 H. pylori-infected patients who had received clarithromycin-based triple therapy.
During a median follow-up of 7.1 years, 153 patients (0.33%) were diagnosed with gastric cancer at a median age of 72.4 years.
The incidence of gastric cancer among the 6,900 patients with diabetes was 7.3 per 10,000 person-years, compared to 4.1 per 10,000 person-years among patients without diabetes, the researchers report in Diabetes Care, online July 5.
In multivariable analysis, the risk of gastric cancer in patients with diabetes was 2.41-fold higher than in those without, a significant difference, with a lower risk among those taking metformin (1.31-fold increased risk) than among those not taking metformin (2.34-fold increased risk).
In subgroup analyses, the increased risk of gastric cancer was only evident among patients with suboptimal diabetes control (mean hemoglobin A1c, 6.0% (42 mmol/mol) or higher) and those not taking metformin, and was only significant for cardia cancer and not for noncardia cancer.
"Targeted screening should be considered after eradication therapy in high-risk H. pylori-infected patients with diabetes," the researchers conclude.
Dr. Leung did not respond to a request for comments.
Diabetes Care 2019.