Objective: to assess the large-scale eradication of Helicobacter pylori infection reduce the benefit of gastric precancerous lesions.
Design: starting from 2004, HP infection and age > 30 Taiwan conducted large-scale eradication of Helicobacter pylori. 13C-urea breath test-positive subjects, endoscopic screening for and 1 week of clarithromycin based triple therapy. For patients with initial therapy fails, use 10 days left-ofloxacin-based triple therapy. Before the main measurement result is chemopreventive (1995~2003) and (2004~2008) prevalence of Helicobacter pylori infection, precancerous lesions that change, changes in the incidence of precancerous lesion and gastric cancer.
Results: the patients each year, and reduce the infection rate of Helicobacter pylori 78.7% (95% confidence interval (CI), 76.8%~80.7%), the estimated incidence of recurrence of infection/lower 1% (95% CI 0.6%~1.4%). Chemoprophylaxis can significantly reduce the incidence of gastric atrophy of 77.2% (95% CI 72.3%~81.2%), but no significant reduction in intestinal metaplasia. Chemoprophylaxis compared the first 5 years, and the lack of endoscopic screening reduces the incidence of chemical prevention of gastric carcinoma during 25% (ratio 0.753,95% CI 0.372~1.524). Peptic ulcer disease dropped 67.4% (95% CI 52.2%~77.8%), and incidence of esophagitis after treatment was 6% (95% CI 5.1%~6.9%).
Conclusion: based on the eradication of Helicobacter pylori infection of people, can significantly reduce the incidence of gastric atrophy, increased occurrence of esophagitis. Whether to reduce the incidence rate of gastric cancer and the ultimate benefits of mortality should be further verified through long-term follow-up.