Multicenter prospective study of a DNA methylation marker for risk stratification of primary gastric cancer after eradication of H. pylori

A multicenter prospective study in Japan evaluated RIMS1 DNA methylation in stomach biopsies after Helicobacter pylori eradication as a marker for risk of development of primary gastric cancer. Among 1624 participants with a median follow-up of 4.05 years, 27 participants developed gastric cancer. Participants in the highest quartile of RIMS1 DNA methylation had a higher gastric cancer risk than participants in the lowest quartile (972.8 versus 127.1 per 100,000 person-years). The univariate HR was 7.7 (95% CI 1.8-33.7) and the age- and sex-adjusted HR was 5.7 (1.3-25.5). As a secondary objective, a cut-off methylation level of 25.7% was obtained to identify a population with a super-high risk based on the number needed to screen of 1000. The authors conclude that a DNA methylation marker can risk-stratify healthy people after H. pylori eradication even though all of them have clinically high risk.