Role of Helicobacter pylori and gastric cancer in Japan

We have published a long-term follow-up study to investigate the development of gastric cancer, also eradication trial in the patients whose gastric cancer was removed by endoscopic mucosal resection (EMR). 1526 patients who underwent endoscopy and were assessed as to the presence of H. pylori infection by histology, rapid urease test and serology. Follow-up endoscopy detected no gastric cancer in negative patients (n=280). On the other hand, after 8 years of follow-up, gastric cancers were discovered in 36 of the 1246 infected patients. Endoscopy after EMR detected a new gastric cancer in only 2 patients in eradication group. On the other hand after 7 years of follow up, in 11 (16%) of the 67 patients in non-treated, new cancer was discovered.The above results suggest that the development of gastric cancer is caused by H. pylori-associated gastritis. Eradication improved active gastritis and at the same time might prevent gastric cancer.