Helicobacter pylori and the prevention of gastric cancer.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Sullivan
Terrence
T
Division of Research and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, Ontario, Canada M5G 2L7. terry.sullivan@cancercare.on.ca
Ashbury
Fredrick D
FD
Fallone
Carlo A
CA
Naja
Farah
F
Schabas
Richard
R
Hébert
Philip C
PC
Hunt
Richard
R
Jones
Nicola
N
D002170:Canada / Q000453:epidemiology; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008403:Mass Screening; D015995:Prevalence; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000517:prevention & control