CLINICAL REVIEWSHelicobacter pylori Eradication Has the Potential to Prevent Gastric Cancer A State-of-the-Art CritiqueMalfertheiner, Peter, M.D.1; Sipponen, Pentti, M.D.2; Naumann, Michael, Ph.D3; Moayyedi, Paul, M.B., Ch.B., Ph.D., M.P.H., F.R.C.P4; Mégraud, Francis, M.D.5; Xiao, Shu-Dong, M.D.6; Sugano, Kentaro, M.D., Ph.D7; Nyrén, Olof, M.D., Ph.D8 the Lejondal H. pylori–Gastric Cancer Task ForceAuthor Information 1Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany 2Department of Pathology, Helsinki University District Central Hospital, Jorvi Hospital, Espoo, Finland 3Institute of Experimental Internal Medicine, Otto-von-Guericke University, Magdeburg, Germany 4Department of Medicine, Division of Gastroenterology, Health Sciences Centre, McMaster University, Hamilton, Ontario, Canada 5Laboratoire de Bacteriologie, Université Victor Segalen Bordeaux 2, Bordeaux, France 6Institute of Digestive Disease, Renji Hospital, Shanghai Second Medical University, Shanghai, China 7Department of Internal Medicine, Division of Gastroenterology, Jichi Medical School, Saitama-shi, Saitama-ken, Japan 8Department of Medical Epidemiology & Biostatistics, Karolinska Institute, Stockholm, Sweden For a list of the Contributors to the Lejondal H. pylori–Gastric Cancer Tast Force, see Appendix. Reprint requests and correspondence: Peter Malfertheiner, M.D., Professor of Medicine, Otto-von-Guericke University, Department of Gastroenterology, Hepatology and Infections Diseases, Leipziger Str. 44, 39120 Magdeburg, Germany. Received October 19, 2004; accepted March 23, 2005. American Journal of Gastroenterology: September 2005 - Volume 100 - Issue 9 - p 2100-2115 Buy Abstract Helicobacter pylori infection continues to play a key role in gastric diseases. Colonization of the gastric mucosa with the bacterium invariably results in the development of chronic gastritis and subsets of patients have a progression of the chronic gastritis to either ulcer or cancer. Epidemiological evidence indicates that the proportion of all gastric cancers attributable to H. pylori infection, and hence potentially preventable upon elimination of this risk factor, is somewhere in the range of 60% to 90%. This portends significant benefit in terms of morbidity and mortality, not least in populations with high prevalence of H. pylori infection coupled with high incidence of gastric cancer. The effect of prophylactic H. pylori eradication on gastric cancer incidence in humans remains unknown, however. Results from randomized trials are eagerly awaited, but availability of strong conclusive results may take many years. A growing number of studies show considerable variation in risk for gastric cancer development, depending on H. pylori strain type and the genetic predisposition of the host. There is also a remote possibility that elimination of the infection may have adverse health implications (e.g., antibiotic resistance), and therefore “simple” risk stratification and targeted chemoprevention is required. Based on “in depth” evidence presented at this workshop, the majority of the scientific task force favored a search-and-treat strategy in first-degree relatives of gastric cancer patients and an overwhelming majority felt that a more general screen-and-treat strategy should be focused in the first instance on a population with a high incidence of H. pylori-associated diseases. © The American College of Gastroenterology 2005. All Rights Reserved.