Treating H. pylori later in life can still cut down risk of stomach cancer

The prevailing perspective has been that eradicating Helicobacter pylori (H. pylori) was a race against time—that treatment at a young age favoured a better prognosis for stomach cancer. However, a new population-based study shows that even older individuals can benefit from treatment. H. pylori infection is a major cause of stomach cancer, and clearing the infection in people with symptoms can help lower the risk of the cancer.However, in older people it was feared that H. pylori caused irreversible damage to the stomach lining that couldn't be reversed, diminishing the effects of antibiotic and proton pump inhibitor (PPI) treatments. Yet, individuals over 70 years of age seem to benefit from late treatment. For 12 years, Korean researchers followed nearly one million individuals aged 20 and older who received initial treatment to eradicate H. pylori between 2009 and 2011. Patients with a history of stomach cancer, gastric adenoma or gastrectomy were excluded, as were patients who developed stomach cancer within 12 months of receiving antibiotic treatment for H. pylori to eliminate pre-existing but undiagnosed cancers. The results were published in the journal Gastroenterology.The study found that the risk of stomach cancer in those who received treatment was significantly lower than in the general population, across all age groups from 30 years of age and older. In the 30-to-39 age group, the incidence rate was 0.72 (95% CI, 0.65-0.80). In those 70 and older, it was even lower at 0.52 (95% CI, 0.49-0.56).However, the researchers caution: “Our results do not mean that it would be beneficial to delay treatment to a later age. Although treatment remains effective in older people, it is preferable to administer it at a younger age.”A notable survival benefitWhile eradicating H. pylori did decrease the risk of developing stomach cancer, it primarily reduced the risk of dying from it. The mortality rate in the 30-to-39 age group decreased by 36% with treatment for H. pylori (SMR = 0.64; 95% CI, 0.48-0.83), while a reduction in mortality of up to 70% was observed in the 50 and older age group (SMR = 0.29; 95% CI, 0.25-0.33). Even the 70 and older age group benefited, with a mortality rate of 0.34 (95% CI, 0.30-0.38) compared to the general population.It is possible that eliminating the infection, even in older individuals, improved patient prognosis by slowing the progression of malignant tumours. Thus, individuals with advanced cancer would potentially benefit from screening and treatment for H. pylori.The treatment had no effect in the 20-to-29 age group. This does not mean that the treatment is ineffective in young individuals, but rather that the study duration was insufficient to capture the critical age at which cancer typically develops. The study authors believe that a 20- or 30-year follow-up would likely have allowed them to observe the effect of treatment at 20 years on the incidence of stomach cancer.The study was conducted in South Korea, where the incidence of H. pylori reaches up to 50% of the population. In France, it is estimated that a quarter of the population is affected.ReferenceJung YS, Tran MTX, Park B, Moon CM. Preventive Effects of Helicobacter pylori Treatment on Gastric Cancer Incidence and Mortality: A Korean Population Study. Gastroenterology. August 2025;169(2):251-260.e4.This article was initially published on our sister site ProfessionSanté.ca and has been translated from its original French.

Treating H. pylori later in life can still cut down risk of stomach cancer

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