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‹ Sun · 17 May 2026
Early cancer detection or prevention

Long-Term Effect of Helicobacter pylori Eradication on Gastric Atrophy and Intestinal Metaplasia After Endoscopic Resection of Gastric Neoplasm: A Follow-Up of a Randomized Controlled Trial

Eliminating H. pylori after early gastric cancer resection reverses stomach damage over years, potentially reducing future cancer risk in vulnerable patients.

This long-term follow-up of the landmark 2018 NEJM RCT demonstrates that H. pylori eradication after endoscopic resection of early gastric cancer leads to substantial regression of gastric atrophy and intestinal metaplasia over a median of 5.9 years, with a nearly 6-fold improvement odds in atrophy. These histological improvements support eradication as a durable intervention to reduce the carcinogenesis cascade in high-risk patients.

What the study was

Study design
RCT follow-up (open-label, long-term histological assessment from prior NEJM 2018 trial)
Population
Patients with early gastric cancer post-endoscopic resection, high-risk background mucosa; 327 of 470 original RCT participants assessed at trial closeout
Sample size
327
Category
Early Detection
Maturity
Validated
Journal
Helicobacter

Why it surfaced

Long-term RCT follow-up demonstrating durable histological benefit of H. pylori eradication (OR 5.81 for GA improvement) in high-risk gastric cancer patients. Directly validates the cancer prevention cascade (Correa pathway reversal). Highest clinical impact among today's finds; practice-relevant for upper GI surveillance programs globally.

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