TOPLINE:

The vast majority of gastric cancers identified in patients with Helicobacter pylori were diagnosed within 1 year of detection of the infection. Treatment or eradication of H pylori did not reduce the short-term risk for gastric cancer, but delayed eradication was linked to an increased risk.

METHODOLOGY:

• Prior studies have shown that H pylori eradication is linked to a reduced risk for gastric cancer, but the benefits often take many years to appear, raising concerns that symptom-based testing might be too late for prevention.
• Researchers conducted a retrospective cohort study to evaluate how many patients already had gastric cancer at the time of H pylori diagnosis and whether treatment or eradication of H pylori changed the subsequent risk for gastric cancer.
• They included adults with a positive stool antigen test for H pylori in an integrated Southern California health system between January 2008 and June 2023, excluding people with prior gastric cancer.
• Patients were categorized by whether they received standard H pylori treatment within 90 days (treated vs untreated) and by eradication status on the basis of subsequent stool antigen results (eradicated, not eradicated, or unknown).
• Data for patients with gastric cancer were extracted from a cancer registry, and the follow-up period began 1 year after the diagnosis of H pylori.

TAKEAWAY:

• The cohort included 60,503 adults who tested positive for H pylori infection (median age, 49.1 years; 62.9% female).
• A total of 173 gastric cancers were diagnosed in the cohort. Of these, 133 (76.9%) were identified within 1 year of H pylori diagnosis, indicating that they were prevalent at the time of infection detection.
• After excluding prevalent cases, 40 new cases of gastric cancer occurred over a median follow-up period of 2.6 years. Treatment or eradication of H pylori was not associated with a reduced risk for the incidence of gastric cancer.
• Each additional year of delay before eradication of H pylori was linked to a 12% increased risk for gastric cancer (hazard ratio per year, 1.12; 95% CI, 1.01-1.25).

IN PRACTICE:

“While eradication [of H pylori] may reduce GC [gastric cancer] risk, this benefit likely requires early detection and adequate follow-up. Our findings support recent guideline changes recommending proactive screening and treatment for [H pylori] in high-risk populations and highlight the need for more comprehensive, upstream approaches to GC prevention in the United States,” the authors of the study wrote.

SOURCE:

The study was led by Will Takakura, MD, Kaiser Permanente Southern California, Panorama City, California. It was published online in Clinical Gastroenterology and Hepatology.

LIMITATIONS:

The follow-up duration was short, which may have missed the long-term benefits of eradication. New cases of gastric cancer were few, and many patients had unknown eradication status, which may have limited statistical power and accuracy. The retrospective design in the health system may have introduced selection bias and limited generalizability.

DISCLOSURES:

The study did not mention any funding source, and the authors reported having no relevant financial disclosures.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.