Holleczek B, et al. - The risk of invasive gastric and esophageal cancer according to H. pylori infection and presence of chronic atrophic gastritis (CAG) was examined in a large prospective population-based cohort study of 9,949 individuals with an average observation time of 13.8 years. During follow-up, noncardia gastric cancer occurred in 30 cases and esophageal cancer occurred in 33 cases. Researchers observed a 5.2-fold and an 18.2-fold (4.3–77.4) increase of noncardia gastric cancer incidence in correlation with infection by H. pylori without and with expression of cytotoxin-associated gene A (CagA). H. pylori-infected individuals showed a 0.65-fold decreased risk of esophageal adenocarcinomas. In participants infected with CagA expressed H. pylori, a 6.4-fold and an 11.8-fold increase of gastric cancer incidence were noted in correlation with the presence of mild/moderate and severe CAG, respectively. The results may assist in risk stratification among H. pylori-infected people and in making recommendations regarding H. pylori screening and treatment among older adults in a Western population.