A reduction in two modifiable risk factors for intestinal-type noncardia gastric adenocarcinoma (NCGA)—infection with the bacteria Helicobacter pylori and smoking—are associated with a significant proportion of the dramatic decline in the disease in the United States over a 30-year period. Using a population-based mathematical simulation model that incorporated risk factor data from the National Health and Nutrition Examination Survey (NHANES) and National Health Interview Survey (NHIS), researchers at Harvard School of Public Health (HSPH) and colleagues estimated that intestinal-type NCGA declined 60% between 1978 and 2008 and found that H. pylori infection and smoking accounted for 47% of the drop. They also predicted that, between 2008 and 2040, U.S. intestinal-type NCGA rates will fall an additional 47%, and that H. pylori and smoking will contribute to more than 80% of the decline.
Jennifer Yeh, research scientist at HSPH’s Center for Health Decision Science, led the study, which appeared May 21, 2013 in PLOS Medicine. Senior author was Sue Goldie, Roger Irving Lee Professor of Public Health in HSPH’s Department of Health Policy and Management and director of the Center for Health Decision Science.
Although gastric cancer has declined in the U.S., it remains the second leading cause of cancer mortality worldwide. The authors hope their findings can provide important insights into effective preventive strategies around the world. “Further discouragement of smoking and reduction of H. pylori infection should be priorities for gastric cancer control efforts,” they wrote.
Gastric cancer prevention (HSPH Center for Health Decision Science)