Helicobacter pylori eradication and gastric cancer: when is the horse out of the barn?

Am J Gastroenterol. 2009 Jun;104(6):1342-5. doi: 10.1038/ajg.2008.15.


Helicobacter pylori infection is a major risk factor for gastric cancer development. Therefore, H. pylori eradication may be an important approach in the prevention of gastric cancer. However, long-term data proving the efficacy of this approach are lacking. This report describes two patients who developed gastric cancer at, respectively, 4 and 14 years after H. pylori eradication therapy. These patients were included in a study cohort of H. pylori-infected subjects who received anti-H. pylori therapy during the early years of development of H. pylori eradication therapy and underwent strict endoscopic follow-up for several years. In both patients, gastric ulcer disease and premalignant gastric lesions, i.e., intestinal metaplasia at baseline and dysplasia during follow-up, were diagnosed before gastric cancer development. These case reports demonstrate that H. pylori eradication does not prevent gastric cancer development in all infected patients after long-term follow-up. In patients with premalignant gastric lesions, in particular in patients with a history of gastric ulcer disease, adequate endoscopic follow-up is essential for early detection of gastric neoplasia.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / etiology*
  • Adenocarcinoma / surgery
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Biopsy
  • Endoscopy, Gastrointestinal
  • Fatal Outcome
  • Female
  • Follow-Up Studies
  • Gastrectomy
  • Gastric Mucosa / microbiology*
  • Gastric Mucosa / pathology
  • Helicobacter Infections / complications
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / drug effects
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / etiology*
  • Stomach Neoplasms / surgery
  • Time Factors


  • Anti-Bacterial Agents