Treatment for Helicobacter pylori appears to reduce the incidence of gastric cancer: eradication effect or screening effect?

We read with interest the report by Doorakkers et al describing the effect of Helicobacter pylori eradication in preventing the development of non-cardia gastric adenocarcinoma in a population-based Swedish cohort.1 The authors used nationwide Swedish registries to investigate the incidence of gastric adenocarcinoma after H. pylori eradication treatment. Specifically, standardised incidence ratios (SIRs) were used to examine the incidence of gastric adenocarcinoma in individuals treated for H. pylori compared with a background population of corresponding age, sex and calendar year distribution. The time trend of the SIRs after H. pylori eradication was assessed for up to 7.5 years.

The results showed that the risk of non-cardia gastric adenocarcinoma sharply decreased over time after eradication treatment, reaching levels below those of the corresponding background population. The SIRs were 10.74 (95% CI 7.77 to 14.46) at 1–3 years, 2.67 (95% CI 1.63 to 4.13) at 3–5 years and 0.43 (95% CI 0.16 to...

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