Gastroenterology

Eradication therapy cuts gastric cancer risk in H. pylori-positive adults

August 13, 2025

Study details: This systematic review and meta-analysis included 11 randomized trials and 13 observational studies evaluating the effect of H. pylori eradication therapy on gastric cancer incidence and mortality. The populations studied were H. pylori-positive adults without baseline gastric neoplasia and those with gastric neoplasia undergoing endoscopic mucosal resection, with a minimum follow-up of two years. Control groups received placebo or no eradication therapy.

Results: Eradication therapy significantly reduced the relative risk (RR) of gastric cancer in healthy H. pylori-positive individuals (RR, 0.64; 95% confidence interval [CI], 0.48–0.84) and in those with gastric neoplasia post-endoscopic mucosal resection (RR, 0.52; 95% CI, 0.38–0.71). Mortality from gastric cancer was also lower in treated healthy individuals (RR, 0.78; 95% CI, 0.62–0.98). Observational studies corroborated these findings, showing a similar reduction in future gastric cancer risk (RR, 0.56; 95% CI, 0.43–0.73) and a pronounced effect in post-resection patients (RR, 0.19; 95% CI, 0.06–0.61).

Clinical impact: These results reinforce the value of H. pylori eradication in preventing gastric cancer, especially in patients with early neoplasia. Routine screening and treatment may be a cost-effective strategy to reduce global gastric cancer burden.

Source:

Ford AC, et al. (2025, August). Gastroenterology. Eradication Therapy to Prevent Gastric Cancer in Helicobacterpylori-Positive Individuals: Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies. https://pubmed.ncbi.nlm.nih.gov/39824392/