Esophagus to Small Intestine

Gastroenterology. 2024;166(2):313–22.e3

Yoo HW, Hong SJ, Kim SH

Helicobacter pylori treatment and gastric cancer risk after endoscopic resection of dysplasia: A nationwide cohort study


Background and aims: The study investigated the association between Helicobacter pylori treatment and the risk of gastric cancer (GC) after endoscopic resection of gastric dysplasia.
Methods: Patients who received endoscopic resection for gastric dysplasia between 2010 and 2020 from Korean nationwide insurance data were included. The authors verified the occurrence of new-onset GC and metachronous gastric neoplasm, which encompasses both cancer and dysplasia, > 1 year after the index endoscopic resection. Newly diagnosed GC ≥ 3 years and ≥ 5 years was regarded as late-onset GC. A multivariable Cox regression model with H. pylori treatment status as a time-dependent covariate was used to determine the risk of GC and metachronous gastric neoplasms.
Results: Gastric dysplasia in 69,722 patients was treated with endoscopy, and 49.5% were administered H. pylori therapy. During the median 5.6 years of follow-up, GC developed in 2406 patients and metachronous gastric neoplasms developed in 3342 patients. Receiving H. pylori therapy was closely related to lower GC risk (adjusted hazard ratio [aHR] = 0.88; 95% confidence interval [CI]: 0.80-0.96). H. pylori treatment also significantly decreased metachronous gastric neoplasm development (aHR = 0.76; 95% CI: 0.70-0.82). Furthermore, H. pylori therapy showed a prominent protective effect for late-onset GC development at ≥ 3 years (aHR = 0.84; 95% CI: 0.75–0.94) and ≥ 5 years (aHR = 0.80; 95% CI: 0.68–0.95).

Conclusions: In this nationwide cohort, Helicobacter pylori therapy after endoscopic resection of gastric dysplasia was associated with a reduced risk of gastric cancer and metachronous gastric neoplasm occurrence.

Prof. Dr. Dr. S.J. Hong, Soon Chun Hyang University College of Medicine, Digestive Disease Center and Research Institute, Soon Chun Hyang University, Bucheon Hospital, Bucheon, South Korea, E-Mail: sjhong@schmc.ac.kr

DOI: 10.1053/j.gastro.2023.10.013

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