After a three-year follow-up period,
9% of the untreated patients developed metachronous gastric
cancer, while none of the patients who underwent H. pylori eradication developed the disease.(38)
In another prospective
observational study, Uemura et al showed that gastric cancer
developed in persons infected with H. pylori, but not in uninfected
persons.(39)
The pooled data from five randomised placebocontrolled H. pylori eradication trials in Asia(40-44) showed that with
H. pylori eradication, the pooled RR of developing gastric cancer
was 0.56 (95% CI 0.40–0.8).(32) However, it must be recognised
that, prior to eradication, irreversible precancerous lesions may
have already arisen, and in such cases, apart from H. pylori
eradication, a strategy of continued surveillance is required.