Diabetes increases Gastric Cancer risk after treatment for H. Pylori infection, finds study

Type 2 diabetes mellitus is associated with gastric cancer after H. Pylori infection treatment, revealed a study published in the Journal of Diabetes Care.

Gastric cancer (GC) is one of the major death-causing cancers worldwide. A number of prior studies have shown an association between Helicobacter Pylori infection and gastric cancer. Diabetes mellitus (DM) is a common and major disease worldwide. Increasing evidence indicates that patients with DM have a higher risk of not only cardiovascular disease but also cancer in various organs. Recently, several investigators have found a possible association between DM and liver, uterus, colon gastric cancers.

The present study was conducted to investigate whether type 2 DM increased risk of Gastric cancer(GC) in patients after they received treatment for H. Pylori infection. In order to achieve this, a team of researchers from the University of Hong Kong and University College London conducted territory-wide cohort study of patients aged ≥45 years who had received clarithromycin-based triple therapy for HP infection between 2003 and 2012 in Hong Kong.

Data were retrieved from a public electronic health database. The observation started from receipt of therapy for HP infection to GC diagnosis, death, or the end of the study (December 2015). Exclusion criteria included type 1 DM, GC diagnosed within the 1st year of HP therapy, prior GC or gastrectomy, and retreatment for HP infection. The adjusted hazard ratio (aHR) of GC with type 2 DM was calculated by using a Cox model that adjusted for 20 covariates (age, sex, comorbidities, and medications) through propensity score regression.

Key Findings

• During a median follow-up of 7.1 years (interquartile range 4.8–9.3 years), 153 of 46,460 patients (0.33%) developed GC at a median age of 72.4 years.


• Type 2 DM was associated with an increased risk of GC.


• Stratified analysis showed an increase in risk for cardia cancer only and in those with suboptimal DM control (time-weighted mean HbA_1c ≥6.0%.

Based on the findings the authors conclude " Type 2 DM is associated with an increased risk of GC among patients in whom HP was eradicated, in particular, those with gastric cardia cancer and those with suboptimal DM control."

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https://doi.org/10.2337/dc19-0437