[Helicobacter pylori eradication therapy does not prevent gastric cancer development in all patients]

We previously reported that eradication of Helicobacter pylori reduced the risk of gastric cancer developing in patients with peptic ulcer diseases. In the present study, we followed up with our patient group to investigate the occurrences and clinical features of gastric cancers that developed after cure of the infection. Prospective post-eradication evaluations were conducted on 1, 674 consecutive patients who had received successful H. pylori eradication therapy. The patients underwent endoscopic examination before eradication therapy to test for peptic ulcers, background gastric mucosal atrophy, and H. pylori infection. After confirmation of the cure of infection, the annual follow-up endoscopy was performed. The patients were followed up to more than 10 years. During the follow-up, their risk of developing gastric cancer after the cure of infection was almost the same as we reported previously. There was still a risk of developing gastric cancer of both the intestinal and diffuse types. The grade of gastric mucosal atrophy present before receiving eradication therapy was closely related to the development of gastric cancer after eradication of H. pylori. The stage of most gastric cancer was at the early TNM stage, but advanced cancer was observed in patients who skipped regular endoscopic surveillance. H. pylori eradication therapy does not prevent gastric cancer development in all infected patients. Thus, it is important to inform patients about the risk of gastric cancer after eradication therapy and to offer them surveillance endoscopy.