Helicobacter pylori and the prevention of gastric cancer

• Published in: Canadian journal of gastroenterology Vol. 18; no. 5; pp. 295 - 302
• Main Authors: Sullivan, Terrence, Ashbury, Fredrick D, Fallone, Carlo A, Naja, Farah, Schabas, Richard, Hébert, Philip C, Hunt, Richard, Jones, Nicola
• Format: Journal Article
• Language: English
• Published: Canada Hindawi Limited 01.05.2004
• Subjects: Canada - epidemiology; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter Infections - epidemiology; Helicobacter pylori; Humans; Mass Screening; Prevalence; Stomach Neoplasms - microbiology; Stomach Neoplasms - prevention & control; Canada
• ISSN: 0835-7900
• DOI: 10.1155/2004/315184

Helicobacter pylori is an important cause of stomach cancer that infects a substantial proportion of the Canadian adult population. H pylori can be detected by noninvasive tests and effectively eradicated by medical treatment. Screening for and treatment of H pylori may represent a significant opportunity for preventive oncology. Cancer Care Ontario organized a workshop held in Toronto, Ontario, on October 24 and 25, 2002, to: review the current state of knowledge regarding H pylori treatment and cancer prevention; determine if there is currently sufficient evidence to consider the promotion of H pylori treatment for the purpose of cancer prevention; identify critical areas for research; and advise Cancer Care Ontario on H pylori and cancer prevention. Workshop participants developed a number of recommendations for research into the relationship between H pylori and stomach cancer, including determining the prevalence of infection in different regions of Canada, the pathogenetic sequence of carcinogenesis from H pylori infection, and the implementation of a prospective observational study. Although the rate of H pylori infection is declining in Canada and the treatment of H pylori is generally accepted to be safe, the evidence to date may not warrant the implementation of population screening for H pylori infection to prevent gastric carcinoma in average-risk populations. Rather, a demonstration project is needed to estimate prevalence, evaluate the merits of screening, measure patient compliance and physician participation, develop education materials, establish a registry for monitoring and evaluation, and develop a quality assurance framework.