Helicobacter pylori Eradication Reduces Risk for De Novo Gastric Cancer

Although Helicobacter pylori is a known risk factor for the development of gastric cancer, cohort studies and randomized, controlled trials have failed to show a significantly reduced risk for de novo gastric cancer with H. pylori eradication.

To further examine this association, investigators retrospectively evaluated de novo gastric cancer risk in a general population of over 10,000 patients in Korea undergoing comprehensive cancer screening, which included baseline and follow-up upper endoscopy and H. pylori testing. During a median follow-up of 5.5 years, results were as follows:

• 31 de novo gastric cancers were detected: 4 among 200 patients with successful H. pylori eradication (0.2%), 6 among 5000 patients without H. pylori (0.1%), and 21 among 3500 patients without eradication (0.6%).

• Eradication of H. pylori was associated with a 70% reduced risk for de novo gastric cancer compared with no eradication (hazard ratio, 0.3).

• Low serum high-density lipoprotein (HDL) level was associated with an increased risk for de novo gastric cancer (hazard ratio, 2.7).

• In an adjusted analysis, de novo gastric cancer was also associated with older age, presence of atrophic gastritis, and a family history of gastric cancer.