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Preventing Gastric Cancer by Eradicating Helicobacter pylori
Gastric infection with Helicobacter pylori initiates mucosal changes that can evolve to adenocarcinoma. Two new reports expand our understanding of the effect of H. pylori eradication on gastric cancer development.
Researchers conducted a meta-analysis of 11 randomized trials and 13 cohort studies that compared outcomes in treated and untreated H. pylori–positive adults. In both groups of studies, gastric cancer incidence was 40% lower in people who underwent H. pylori eradication. All but two of these studies were from eastern Asia.
In a retrospective study from Nordic countries (Denmark, Sweden, Norway, Finland, and Iceland), researchers tracked outcomes among 700,000 people treated for H. pylori infection. The incidence of gastric carcinoma was twice that of the general population in the first 5 years after treatment, likely reflecting H. pylori–related carcinogenesis that already was underway, but after 11 years, the incidence fell to that of the general population and remained there.
Comment
Together, these two reports provide additional evidence that eradicating H. pylori can lower risk for gastric cancer, not only in Asian countries with a high prevalence of gastric cancer but also in non-Asian populations.
In the U.S., routine screening for gastric cancer or H. pylori infection is not recommended. However, some experts recommend screening — by stool antigen tests, urea breath testing, or endoscopy — in high-risk asymptomatic people, such as those from countries with a high gastric cancer prevalence and those who have first-degree relatives with gastric cancer. Clinicians should make sure that all H. pylori–positive patients receive adequate eradication therapy.
Citation(s)
Author:
Ford AC et al.
Title:
Eradication therapy to prevent gastric cancer in Helicobacter pylori–positive individuals: Systematic review and meta-analysis of randomized controlled trials and observational studies.
Source:
Gastroenterology
2025
Aug
; [e-pub].
(Abstract/FREE Full Text)
Author:
Wiklund A-K et al.
Title:
Risk of gastric adenocarcinoma after eradication of Helicobacter pylori.
Source:
Gastroenterology
2025
Aug
; [e-pub].
(Abstract/FREE Full Text)
Author:
Shah SC et al.
Title:
AGA clinical practice update on screening and surveillance in individuals at increased risk for gastric cancer in the United States: Expert review.
Source:
Gastroenterology
2025
Feb
; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Allan S. Brett, MD