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Only complete eradication of Helicobacter pylori infection, not treatment alone, will reduce the risk for developing stomach cancer, according to a study recently published in Gastroenterology.

Shria Kumar, M.D., from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues evaluated data for 371,813 patients from the Veterans Health Administration (median age, 62 years; 92.3 percent male) who received a diagnosis of H. pylori infection (from 1994 through 2018). The authors sought to calculate the incidence of and risk factors associated with nonproximal gastric adenocarcinomas.

The researchers found that the cumulative incidence of cancer at five, 10, and 20 years after detection of H. pylori infection was 0.37, 0.5, and 0.65 percent, respectively. Older age at time of detection of H. pylori infection (subhazard ratio [sHR], 1.13; 95 percent confidence interval [CI], 1.11 to 1.15; P < 0.001), black/African-American race (sHR, 2.00; 95 percent CI, 1.80 to 2.22) Asian race (sHR, 2.52; 95 percent CI, 1.64 to 3.89; P < 0.001 for race), Hispanic or Latino ethnicity (sHR, 1.59; 95 percent CI, 1.34 to 1.87; P < 0.001), and history of smoking (sHR, 1.38; 95 percent CI, 1.25 to 1.52; P < 0.001) were factors associated with cancer. There was still an increased risk for cancer among patients who received treatment for their H. pylori infection (sHR, 1.16; 95 percent CI, 0.74 to 1.83; P = 0.51), although confirmed H. pylori eradication after treatment was associated with a reduced risk for gastric cancer (sHR, 0.24; 95 percent CI, 0.15 to 0.41; P < 0.001).

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