• J Formos Med Assoc · Dec 2022

    Review

    Mass screening and eradication of Helicobacter pylori as the policy recommendations for gastric cancer prevention.

    • Tsung-Hsien Chiang, Hsiu-Chi Cheng, Shu-Lin Chuang, Yi-Ru Chen, Yu-Hsin Hsu, Tsui-Hsia Hsu, Li-Ju Lin, Yu-Wen Lin, Chia-Hsiang Chu, Ming-Shiang Wu, and Yi-Chia Lee.
    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan.
    • J Formos Med Assoc. 2022 Dec 1; 121 (12): 237823922378-2392.

    AbstractGastric cancer is an inflammation-related cancer triggered by Helicobacter pylori infection. Understanding of the natural disease course has prompted the hypothesis that gastric cancer can be prevented by administering a short-course antibiotic treatment to eradicate the H. pylori infection and interrupt this carcinogenic cascade. Results from randomized controlled trials and cohort studies have repeatedly confirmed this concept, which has moved attention from individual management of H. pylori infection to population-wide implementation of screening programs. Such a paradigm shift follows a three-tier architecture. First, healthcare policy-makers determine the most feasible and applicable eligibility, invitation, testing, referral, treatment, and evaluation methods for an organized screening program to maximize the population benefits and cost-effectiveness. Second, provision of knowledge and effective feedback to frontline general practitioners, including choice of diagnostic tests, selection of eradication regimens, and the indication of endoscopic examination, ensures the quality of care and increases the likelihood of desired treatment responses. Third, initiatives to raise population awareness are designed regarding the impact of H. pylori infection and risky lifestyle habits on the stomach health. These programs, with increased accessibility and geographic coverage in progress, will accelerate the decline in morbidity, mortality, and associated costs of this preventable malignancy.Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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