Chemoprevention trial on precancerous lesions of the stomach in Venezuela: summary of study design and baseline data.

A double-blind, placebo-controlled trial is being conducted in a population at high risk for gastric cancer in Venezuela. The main aim of the trial is to assess the effect of antioxidant vitamins (beta-carotene, vitamin C and vitamin E) in blocking the progression of precancerous lesions of the stomach. Within the framework of a screening programme for stomach cancer, 2200 subjects of 35-69 years of age have been recruited. At study entry, a dietary questionnaire was completed, and gastroscopy with the collection of seven gastric biopsies was performed. After baseline examinations, the study participants were randomized to receive antioxidant treatment or placebo for three years. The treatment phase will be completed in mid-1998. At the end of the treatment phase, the investigations performed at study entry will be repeated. Before the initiation of the trial, various pilot studies were carried out that showed an extremely high prevalence of Helicobacter pylori infection (over 90%). Two eradication trials using anti-H. pylori treatments that give good results in Europe and North America gave very poor results in our study population. The low eradication rates achieved (5-20%) suggest a high prevalence of antibiotic-resistant H. pylori strains or high reinfection rates. These disappointing results led to deletion of an anti-H. pylori treatment phase of the main trial.