23Evidence A

Testing for Helicobacter pylori and eradicating it if positive

A 22-year follow-up study conducted in Linqu, Shandong, showed that individuals who had Helicobacter pylori eradicated had roughly half the risk of developing gastric cancer and about 40% lower risk of dying from it. Testing costs just 100–200 yuan, while eradication requires a two-week medication regimen.

Cost

The carbon-13 or carbon-14 breath test costs 100 to 200 yu…

Benefit

This randomized trial in Linqu, Shandong, followed participants for 22 years. Those who underwent Helicobacter…

Cost

The carbon-13 or carbon-14 breath test costs 100 to 200 yuan. Eradicating the bacteria requires taking four different medications for two weeks; the medication cost for that period is 200 to 500 yuan. The main difficulty is ensuring the full two-week course of medication is taken on schedule.

Benefit

This randomized trial in Linqu, Shandong, followed participants for 22 years. Those who underwent Helicobacter pylori eradication therapy saw their risk of gastric cancer drop by nearly half. The original odds ratio was 0.48, with a 95% confidence interval ranging from 0.32 to 0.71. Their risk of dying from gastric cancer also fell by roughly 38% (hazard ratio 0.62; 95% CI 0.39–0.99).

Original sources

Li WQ 等 (2019). Effects of Helicobacter pylori treatment and vitamin and garlic supplementation on gastric cancer incidence and mortality: follow-up of a randomized intervention trial. BMJ. https://doi.org/10.1136/bmj.l5016

Open source link
Book note

Reinfection can still occur after eradication, so it is advisable for all household members to be tested and treated together. This trial involved residents of an area with a high incidence of gastric cancer; people living in regions with lower incidence may gain considerably less benefit.

My note