The effect of eradication of Helicobacter pylori on gastric cancer prevention in healthy asymptomatic populations

BackgroundAlthough many epidemiologic studies have evaluated the effect of Helicobacter pylori eradication on gastric cancer, the effect is still uncertain in general populations. We evaluated whether H.pylori eradication would affect the incidence of gastric cancer in healthy asymptomatic populations. Materials and methodsWe performed a retrospective cohort study in 38984 asymptomatic individuals, who underwent health screening examinations more than twice between 2005 and 2016. We investigated the incidence of gastric cancer among 3 groups: those without H.pylori infection (Hp-negative group), those with H.pylori eradication (eradication group), and those without H.pylori eradication (non-eradication group). ResultsThe cumulative incidence of gastric cancer was 54.5 cases per 100000 person-years during a median of 6.4years. In a multivariate analysis using the Cox proportional hazard model, the cumulative incidence of gastric cancer in the non-eradication group was significantly higher than those in the Hp-negative (hazard ratio [HR] 4.12, P<.001) and eradication groups (HR 2.73, P=.001). However, the cumulative incidence of gastric cancer was not significantly different between the eradication and Hp-negative groups. Other risk factors for gastric cancer occurrence were age, smoking, family history of gastric cancer, and gastric atrophy. The standardized incidence ratios of the age groups above 40 and below 70 in the eradication group were all significantly decreased. ConclusionsHelicobacter pylori eradication reduced the cumulative incidence of gastric cancer in healthy asymptomatic population, and the effect of H.pylori eradication on the prevention of gastric cancer was observed in all ages.