29 Recently, there has been a decreasing trend of H. pylori infection in patients with PUD in the United States. 30 Gastric cancer H. pylori can turn chronic gastritis into atrophic gastritis, intestinal metaplasia, dysplasia, and eventually adenocarcinoma via Correa's precancerous cascade. 31 H. pylori ‐induced chronic gastritis generates increased epithelial cell turnover and reactive oxygen species, resulting in DNA damage along with microRNA dysregulation. 32 Furthermore, H. pylori can induce DNA methylation changes, causing epigenetic aberrations in gastric epithelial cells.
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