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