Original Article—Alimentary Tract

Journal of Gastroenterology

, Volume 46, Issue 3, pp 318-324

First online:

The long-term risk of gastric cancer after the successful eradication of Helicobacter pylori

  • Susumu TakeAffiliated withDepartment of Internal Medicine, Fukuwatari Municipal HospitalDepartment of Internal Medicine, Nippon Kokan Fukuyama Hospital
  • , Motowo MizunoAffiliated withDepartment of Gastrointestinal Endoscopy, Hiroshima City Hospital Email author 
  • , Kuniharu IshikiAffiliated withDepartment of Internal Medicine, Nippon Kokan Fukuyama Hospital
  • , Tomowo YoshidaAffiliated withDepartment of Internal Medicine, Nippon Kokan Fukuyama Hospital
  • , Nobuya OharaAffiliated withDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • , Kenji YokotaAffiliated withDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • , Keiji OgumaAffiliated withDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • , Hiroyuki OkadaAffiliated withDepartment of Medicine and Medical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • , Kazuhide YamamotoAffiliated withDepartment of Medicine and Medical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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Abstract

Background

We previously reported that eradication of Helicobacter pylori reduced the risk of developing gastric cancer in patients with peptic ulcer diseases. In the present study, we further followed up our patient group to investigate the occurrence and clinical features of gastric cancers that developed after cure of the infection.

Methods

Prospective post-eradication evaluations were conducted on 1674 consecutive patients who had received successful H. pylori eradication therapy. The patients had undergone endoscopic examination before eradication therapy to evaluate peptic ulcers, background gastric mucosal atrophy, and H. pylori infection. After confirmation of cure of the infection, follow-up endoscopy was performed yearly.

Results

The patients were followed for up to 14.1 years (a mean of 5.6 years). During the follow-up, gastric cancer developed in 28 of the 1674 patients as long as 13.7 years after the cure of H. pylori infection. The risk of developing gastric cancer was 0.30% per year. Histologically, 16 of the gastric cancers were the intestinal type and 12 were the diffuse type; the risk of each cancer type was 0.17 and 0.13% per year, respectively. There was no significant inflammatory cell infiltration in the background gastric mucosa at the time the cancers were recognized.

Conclusion

There is a risk of developing gastric cancer of both the intestinal and diffuse types even after the cure of H. pylori infection and extinction of gastric inflammation. It is important to inform patients about the risk of gastric cancer after eradication therapy and offer them surveillance endoscopy.

Keywords

Eradication therapy Gastric cancer Helicobacter pylori