Angelo Zullo, Giulio Cozza, Guido Manfredi, Saverio Alicante, Andrea Mega, Eugenio Marconato, Salvatore Russo, Benedetta Toro, Luca De Luca, Marco Magistroni, Bastianello Germanà, Nunzia Russo, Elisabetta Martinelli, Alessandra Loiodice, Dino Vaira, Giulia Fiorini, Giuseppe Scaccianoce, Berardino D'Ascoli, Roberto Vassallo, Vincenzo De Francesco, Gianluca Esposito, Irene Ligato, Marcello Maida, Federico Bonomo, Giovanna Ruggiero, Andrea Boccuto, Francesca Galeazzi, Anna Ros, Angelo Milano, Rachele Ciccocioppo, Fabio Monica, Marco Sartori, Giulia Leonardi, Raffaele Manta
Background/Objectives: H. pylori is the main preventable risk factor for gastric cancer through the development of extensive precancerous lesions, namely mucosal atrophy and intestinal metaplasia. Methods: This multicenter, nationwide study enrolled consecutive patients who underwent their first upper gastrointestinal endoscopy with standard biopsies. Clinical, endoscopic and histological data were gathered for statistical analysis using both univariate and multivariate analyses. Results: Data from 775 patients were collected, and H. pylori infection was detected in 172 (22.2%) cases. The infection prevalence significantly increased with age, and it was significantly higher in patients aged ≥50 years compared to younger patients (26.2% vs. 13.7%; p < 0.001; OR: 2.23; 95% CI = 1.48-3.36). The prevalence of extensive gastric precancerous lesions was 2.6%. The multivariate analysis showed that H. pylori infection (OR: 4.77; 95% CI = 1.51-15; p = 0.007), family history of gastric cancer (OR: 4.86; 95% CI = 1.36-15; p = 0.007), and age (OR: 1.07; 95% CI = 1.02-1.13; p = 0.007) independently increased the risk of these lesions. Conclusions: Data provided by this large study on the endoscopic prevalence of both H. pylori infection and extensive precancerous lesions in the stomach may be useful for designing preventive strategies aimed at reducing gastric cancer mortality.