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Preventive Effect of Helicobacter pylori Treatment on Gastric Cancer Incidence and Mortality: A Korean Population
Yoon Suk Jung1, Mai Thi Xuan Tran2, Boyoung Park3
1Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Background & Aims:
Helicobacter pylori (H pylori) infection is a major risk factor for gastric cancer (GC); however, whether H pylori eradication (HPE) benefits the older population remains unclear. We compared GC incidence and mortality between H pylori-treated individuals and the general population, stratified by age.
Methods:
We conducted a population-based study in South Korea involving 916,438 individuals aged ≥20 years who underwent HPE therapy between 2009 and 2011, with follow-up until 2021. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) for GC were calculated, comparing H pylori-treated individuals with the general population.
Results:
The mean follow-up period was 12.4 ± 1.1 years. GC incidence and mortality rates were significantly lower in H pylori-treated individuals than in the general population across all age-groups (30-39, 40-49, 50-59, 60-69, and ≥70 years), except for the 20 to 29 years age-group. Notably, in the 70 to 74, 75 to 79, and ≥80 years age-groups, GC incidence and mortality in H pylori-treated individuals remained significantly lower. The SIRs for these groups were 0.56 (95% confidence interval [CI], 0.52-0.61), 0.48 (95% CI, 0.42-0.54), and 0.36 (95% CI, 0.28-0.46), respectively, and the SMRs were 0.30 (95% CI, 0.25-0.35), 0.38 (95% CI, 0.31-0.47), and 0.43 (95% CI, 0.30-0.59), respectively.
Conclusions:
HPE may help prevent GC and improve survival in adults of all ages, including those aged ≥70 years. These findings suggest that HPE benefits not only younger adults but also older adults. HPE treatment is preferable at a younger age, but older age may not be a limiting factor for the treatment.
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