A Close Follow-Up Strategy in the Short Period of Time after <b><i>Helicobacter pylori</i></b> Eradication Contributes to Earlier Detection of Gastric Cancer

Abstract

<b><i>Introduction:</i></b> The purpose of this study was to optimize the surveillance frequency and period for efficient detection of early gastric cancer (EGC) after <i>Helicobacter pylori</i> (HP) eradication. <b><i>Methods:</i></b> Data from patients with eradicated HP infection were extracted from the endoscopy databases of two institutions from January 2016 to March 2021. The patients were divided into a close follow-up group with frequent surveillance after eradication and an open follow-up group with an intermittent surveillance method, and the cases of post-eradication EGC found in the two groups were analyzed. <b><i>Results:</i></b> Thirty-six out of 9,322 patients (0.39%) in the close follow-up group and 20 out of 11,436 patients (0.17%) in the open follow-up group were found to have EGC. The cumulative incidence of EGC after eradication was significantly higher in the close follow-up group (<i>p</i> = 0.004). The duration between eradication and EGC detection was significantly shorter in the close follow-up group (51.7 vs. 90.5 months, <i>p</i> = 0.002). A logistic regression model revealed that duration after eradication was an independent predictor for detecting EGC in the close follow-up group (<i>p</i> = 0.045). A Cox proportional hazards model revealed that the close follow-up strategy was effective in patients with an eradication duration of less than 65 months to identify EGC (<i>p</i> = 0.015), but there was no difference between the two strategies in patients with an eradication duration of more than 65 months (<i>p</i> = 0.624). <b><i>Discussion/Conclusions:</i></b> Frequent surveillance after HP eradication is efficient for the early detection of EGC during the first 65 months.