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Helicobacter pylori infection is strongly associated with gastric cancer. This relation was examined in a prospective cohort study from Taiwan. The study included 1225 consecutive patients (mean age, 54) who were diagnosed at endoscopy with nonulcer dyspepsia, gastric ulcer, or duodenal ulcer. About half of the patients (618) were H. pylori-positive by histologic examination or urease testing; 59% of infected patients (mainly those with ulcers) received eradication therapy, which was initially successful in most patients. Both infected and noninfected patients underwent surveillance endoscopy about every 2 years.
During a mean follow-up of 6.3 years, seven gastric adenocarcinomas and one lymphoma (a MALToma) were diagnosed in the 618 patient…