Table 1.

RCTs evaluating the association between H pylori eradication and gastric cancer

First Author, Publication year	Country/Region	Study Population	Intervention	Follow-up	Outcome Measures
Choi et al,19 2020	Korea, single center	Participants with a family history of gastric cancer, n = 1826 randomized (n = 1587 evaluated for H pylori eradication)	Lansoprazole 30 mg, Amoxicillin 1g, Clarithromycin 500 mg BID × 7 d Placebo × 7 d H pylori eradication = 70.1%	Median duration of follow-up was 9.2 y (IQR, 6.2–10.6) and 10.2 y (IQR, 8.9–11.6) for incident gastric cancer and overall survival, respectively	Incident gastric cancer Overall survival Incident gastric adenoma
Correa et al23 2000 Correa et al,106 2001	Colombia, 2 communities in Narino Province	Participants with confirmed histologic diagnoses of gastric preneoplasia, n = 976 randomized (n = 852 in intention to treat; n = 631 complete case analyses); age 29–69, mean 51.1 y; 46.1% male	Bismuth 262 mg, amoxicillin 500 mg, metronidazole 375 mg TID × 14 d With or without dietary supplements Placebo With or without dietary supplements H pylori eradication rate = 58.0%	Cited analysis, 6 y. Note: multiple points of follow-up have been published to date, with the most recent a 16-y analysis.107	Progression of preneoplastic lesions (based on histologic score, and global assessment). Gastric cancer outcome published separately108 Relative risk of progression, no change, regression of histologic lesions
Leung et al,34 2004	China, 11 villages in Yantai County, Shandong Province	Participants with vs without dyspepsia, who underwent upper endoscopy with biopsy. n = 587 randomized (34% with gastric preneoplasia at baseline); age 35–75 y, mean, 52.0 y; 47.8% male Note: 33.7% with preneoplasia at baseline	Omeprazole 20 mg, amoxicillin 1g, clarithromycin 500 mg BID × 7 d Placebo × 7 d H pylori eradication rate = 55.6%	Cited analysis, 5 y Note: 10-y follow-up also published.108	Histologic outcomes at 2 and 5 y (subsequently, 8 and 10 y)
Saito et al 2005 (abstract only; full study not published as of Feb. 2020)	Japan, 145 centers	Participants were healthy volunteers with H pylori infection. n = 629 randomized; age 20–59 y, mean not reported	Lansoprazole 30 mg, amoxicillin 1.5 g, clarithromycin 400 mg once daily × 7 d No eradication H pylori eradication rate = 74.4%	Follow-up stated as “≥4y”	Histologic regression or progression of atrophy by at least 1 grade (Note: did not report on gastric cancer incidence, although this was a priori planned outcome)
Wong 200432	China, 7 villages in Changle Country, Fujian Province	Participants undergoing screening endoscopy (age 35–65 y, mean 42.2 y). n = 2423 evaluated, and n = 1628 with H pylori infection but without endoscopic lesions (eg, peptic ulcer) were randomized Note: 37.7% with premalignant lesions at baseline (gastric atrophy, intestinal metaplasia, gastric cancer)	Omeprazole 20 mg, amoxicillin/clavulanic acid 750 mg, metronidazole 400 mg BID × 14 d Placebo × 14 d H pylori eradication rate = 83.7%	Follow-up time, 7.5 y	Incidence of gastric cancer Incidence in those with vs without premalignant lesions
Wong et al,30 2012	China, 12 villages Linqu County, Shandong Province	Participants with H pylori infection and advanced gastric lesions (severe chronic atrophy, intestinal metaplasia, dysplasia); age 35–64 y, mean 53 y n = 1024 randomized, 2 × 2 factorial design ALL participants had premalignant lesions at baseline	Omeprazole 20 mg, amoxicillin 1g, clarithromycin 500 mg BID × 7 d PLUS placebo BID, OR PLUS celecoxib Placebo Celecoxib + placebo H pylori eradication rate = 63.5%	Follow-up time, 5 y	Gastric cancer Regression or progression of gastric premalignant lesions
You et al,33 2006	China, 13 villages Linqu County, Shandong Province	Participants were selected randomly and underwent upper endoscopy, n = 2258 participants randomized; age 35–64 y, mean 46.8 y 2 × 2 × 2 factorial design Note: H pylori confirmed via serologic testing 64% had preneoplastic lesions at baseline	Omeprazole 20 mg, Amoxicillin 1g BID × 14 d a. with or without vitamin or garlic supplementation Placebo ± vitamin or garlic supplementation “Vitamins” = vitamin C, E, selenium Garlic = garlic oil and Kyolic aged garlic extract	Follow-up time, 14.7 y Note: multiple points of follow-up have been published to date, with the most recent a 22-y analysis.82	Prevalence of dysplasia or gastric cancer Prevalence of other precancerous lesions (severe chronic atrophic gastritis, intestinal metaplasia) Average ‘severity’ score

Abbreviation: BID, 2 times per day; IQR, interquartile range; TID, 3 times per day.

Data from Refs.^{19,23,29,30,32–34,82,106–108}