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Does Helicobacter pylori eradication really reduce the risk of gastric cancer at the population level?
  1. Zhu Wang,
  2. Yang Yu,
  3. Wenjuan Yang,
  4. Bin Chen,
  5. Xiao Li
  1. Correspondence to Professor Xiao Li, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; simonlixiao{at}gmail.com

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The development of gastric cancer is related to multiple factors, including gene, diet, environment and Helicobacter pylori infection. The Maastricht IV consensus stated that the eradication of H pylori reduces the risk of gastric cancer development.1 Although the results from epidemiological and animal studies support this statement, no existing human clinical trial has resulted in the same outcome. However, H pylori eradication for gastric cancer prevention is still recommended in the consensus (recommendation level 1C). We believe it may be premature to put forward such a statement based on existing evidence.

To investigate whether enough evidence exists to support H pylori eradication at the population level, we examined the randomised controlled clinical trials (RCTs) referenced in the consensus. The RCT conducted by Wong et al2 …

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