title: Seventeen-year effects of eradicating Helicobacter pylori on the prevention of gastric cancer in patients with peptic ulcer; a prospective cohort study.
abstract: BACKGROUND
  We previously reported that eradication of Helicobacter pylori in our cohort of patients with peptic ulcer disease reduced their risk of developing gastric cancer to approximately one-third after a mean follow-up period of 3.4 years (up to 8.6 years). We have now followed these patients for a longer period.
  
  
  METHODS
  A total of 1,222 consecutive patients with peptic ulcer diseases who completed more than 1-year follow-up after receiving H. pylori eradication therapy were followed with annual endoscopic surveillance for a mean of 9.9 years (as long as 17.4 years).
  
  
  RESULTS
  H. pylori infection was judged cured in 1,030 patients (eradication-success group) but persisted in 192 (eradication-failure group) after initial eradication therapy. In the eradication-failure group, 114 patients received re-treatment at a mean of 4.4 years after the start of follow-up, and 105 of these were cured of infection. Gastric cancer developed in 21 of the 1,030 patients in the eradication-success group and in nine of the 192 in the failure group (p = 0.04). The risk of developing gastric cancer in the eradication-success group (0.21 %/year) was significantly lower than that in the failure group (0.45 %, p = 0.049). The longest interval between the initial H. pylori eradication and the occurrence of gastric cancer was 14.5 years in the eradication-success group and 13.7 years in the eradication-failure group.
  
  
  CONCLUSIONS
  A prophylactic effect for gastric cancer persists for more than 10 years after H. pylori eradication therapy, but we should be aware that cancer can develop even after that interval.
authors.affiliation: Department of Internal Medicine, Fukuwatari Municipal Hospital, Okayama, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Take
authors.forename: Motowo
authors.initials: M
authors.lastname: Mizuno
authors.forename: Kuniharu
authors.initials: K
authors.lastname: Ishiki
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Hamada
authors.forename: Tomowo
authors.initials: T
authors.lastname: Yoshida
authors.forename: Kenji
authors.initials: K
authors.lastname: Yokota
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D055815:Young Adult