H. pylori stool antigen and fecal immunochemical tests combo fails to lower gastric cancer mortality: JAMA

• The screening participation rates for individuals who were invited were 35.7% for FIT alone and 49.6% for HPSA + FIT. Of the 12,142 individuals whose HPSA results were positive, 8664 underwent antibiotic therapy, and 91.9% had their infection eradicated.
• The incidence rates of gastric cancer were 0.037% in the FIT-alone group and 0.032% in the HPSA+FIT group. The death rates from gastric cancer were 0.013% in the FIT-alone group and 0.015% in the HPSA+FIT group.
• Following post hoc analysis to account for variations in screening participation, follow-up duration, and patient characteristics, an invitation for HPSA + FIT was linked to decreased incidence of gastric cancer but not gastric cancer death when compared to FIT alone.
• The most frequent side effects among people who took antibiotics were dyspepsia or decreased appetite and diarrhea or stomach discomfort.

Overall, an offer to test for H pylori stool antigen in conjunction with FIT did not significantly lower incidence of gastric cancer when compared to an invitation for FIT alone, although the results might have been influenced by variations in screening participation and follow-up time between the two groups.

Source:

Lee, Y.-C., Chiang, T.-H., Chiu, H.-M., Su, W.-W., Chou, K.-C., Chen, S. L.-S., Yen, A. M.-F., Fann, J. C.-Y., Chiu, S. Y.-H., Chuang, S.-L., Chen, Y.-R., Chen, S.-D., Hu, T.-H., Fang, Y.-J., Wu, M.-S., Chen, T. H.-H., Yeh, Y.-P., Lin , Jaw-Town, … Hsu, C.-Y. (2024). Screening for Helicobacter pylori to Prevent Gastric Cancer. In JAMA. American Medical Association (AMA). https://doi.org/10.1001/jama.2024.14887