Gut Liver.
2016 Jan;10(1):12-26. 10.5009/gnl15091.
Mass Eradication of Helicobacter pylori to Prevent Gastric Cancer: Theoretical and Practical Considerations
- Affiliations
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- 1Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. mingshiang@ntu.edu.tw
- 2Institute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taipei, Taiwan.
- 3Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
- 4Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan.
- 5Department of Medicine, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, TX, USA.
- KMID: 2382339
- DOI: http://doi.org/10.5009/gnl15091
Abstract
- Although the age-adjusted incidence of gastric cancer is declining, the absolute number of new cases of gastric cancer is increasing due to population growth and aging. An effective strategy is needed to prevent this deadly cancer. Among the available strategies, screen-and-treat for Helicobacter pylori infection appears to be the best approach to decrease cancer risk; however, implementation of this strategy on the population level requires a systematic approach. The program also must be integrated into national healthcare priorities to allow the limited resources to be most effectively allocated. Implementation will require adoption of an appropriate screening strategy, an efficient delivery system with a timely referral for a positive test, and standardized treatment regimens based on clinical efficacy, side effects, simplicity, duration, and cost. Within the population, there are subpopulations that vary in risk such that a "one size fits all" approach is unlikely to be ideal. Sensitivity analyses will be required to identify whether the programs can be utilized by heterogeneous populations and will likely require adjustments to accommodate the needs of subpopulations.
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