Comparison of Cancer Worries for Gastric Cancer by <i>Helicobacter Pylori</i> Infection Status at Health Check-Up Setting in Japan

Helicobacter pylori (HP) infection is the major cause of gastric cancer (GC). No reports have been published on the effects of HP infection on anxiety for GC, although the majority of HP-positive subjects received eradication therapy intending to reduce their risk of GC in Japan. This study aimed to investigate the relationship between cancer worry (CW) for GC and participants' HP infection status. The original study was a quantitative, self-administered questionnaire survey to investigate CW for esophageal cancer in Barrett's esophagus. The present study used the same dataset on CW against GC. Participants were recruited between May 2021 and March 2022 from three health screening facilities in Akita Prefecture, Japan. The Cancer Worry Scale was used to quantitatively assess the fear of developing cancer. Logistic regression analyses were used to investigate factors associated with excessive CW (defined as ≥ 13). A total of 303 respondents were included. Excessive CW accounted for 63.0% (92/146) in HP-negative, 55.0% (11/20) in HP-positive, and 71.5% (98/137) in HP-eradicated patients. While the presence of upper gastrointestinal symptoms and subnormal mental health quality were significantly associated with excessive CW, the status of HP infection did not affect it. There is a significant discrepancy between CW for GC and actual GC risk, defined as their HP infection status, among those undergoing GC screening. It may be necessary to provide appropriate patient education when introducing risk-based (mainly HP-based) stratified screening for GC shortly in Japan.