Background: Although H.pylori is a human carcinogen agent, the efficacy of its eradication on gastric cancer prevention is yet to be demonstrated. Piedmont, Northwest Italy, is an area with a relatively high incidence of gastric cancer.

Methods: A retrospective, population-based study was performed among all the dyspeptic outpatients (38,514) afferent to the Gastroenterology Unit of Mauriziano U.I Hospital, Turin, Italy. Exposure to H.pylori was assessed using 13C Urea Breath test from 1997 to 2008 by means of mass spectrometry. The incidence of gastric cancer was evaluated among all dyspeptic patients (28,900) submitted to upper endoscopy at the same Gastroenterology Unit, over the years 2000-2008. Data were analysed by chi square test and Pearson r correlation.

Results: H.pylori infection overall prevalence was 34.5% and decreased from 36% to 32% over the 1997-2008 period. (p<0.01). Among the 12,662 H.pylori+ patients, at least 9,530 repeated the test for eradication verification (75.3%). The overall eradication rate was 65%. Gastric cancer incidence decreased from 0.0143% to 0.0089% over the 2000-2008 period. A significant positive correlation (p<0.02) between gastric cancer incidence and H.pylori infection prevalence over the studied period was found (R2= 0.621). 

Conclusions: Prevalence of H.pylori infection has decreased significantly over the last decade. This trend parallels the incidence of gastric cancer. One of the causes may be the high level of interest in the eradication treatment, not less than 75.3%, with an eradication success rate of 65.5%, which is remarkable in “real life” setting, out of controlled trials. Our data demonstrate that eradication of H.pylori is effective in preventing gastric cancer development. Test & treat approach in dyspeptic reveals to be effective on clinical and social 
basis.

Keywords: Helicobacter pylori infection; Gastric cancer; Epidemiology; Dyspeptic patients