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H. pylori Gastric Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersH. pylori Gastric CancerSCE Medical Oncology

A 68-year-old man with advanced gastric cancer is being evaluated for molecular profiling. The pathologist reports Helicobacter pylori is identified in the specimen. Is there a role for H. pylori eradication in the context of advanced gastric cancer?

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Correct answer: D — While H. pylori eradication does not affect advanced gastric cancer outcome, it is recommended for early-stage disease (after endoscopic resection) to reduce metachronous second primary risk — IARC has classified H. pylori as a Group 1 carcinogen

H. pylori is the strongest known risk factor for gastric adenocarcinoma (IARC Group 1 carcinogen). For early gastric cancer treated with endoscopic resection, eradication reduces metachronous second primary risk by approximately 50% (Choi et al NEJM 2018). For advanced/metastatic gastric cancer, eradication does not affect oncological outcome. The broader public health role of H. pylori screening and eradication for gastric cancer prevention is an active area of research.

Reference: ESMO 2024 Gastric Cancer; IARC H. pylori; Choi et al NEJM 2018