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EUROHELICAN ACCELERATING GASTRIC CANCER REDUCTION THROUGH HELICOBACTER PYLORI ERADICATION - FIRST SCREEN AND TREAT APPLICATION STUDY IN EUROPE

Bojan Tepes 1, Tatjana Kofol Bric 2, Mitja Oblak 2, Marcel Kralj 2, Jernej Završnik 3, Helena Blažun Vošner 3, Nataša Maguša Lorber 3, Nataša Maguša Lorber 3

Affiliations

1 DC ROGASKA d.o.o., Rogaska Slatina, Slovenia|||National Institute of Public Health, Ljubljana, Slovenia|||DC Rogaska, Rogaska Slatina, Slovenia

2 NIJZ, Ljubljana, Slovenia

3 CHC Maribor, Maribor, Slovenia

Summary

AI Generated

A screen-and-treat study for Helicobacter pylori in Slovenia enrolled 2,105 asymptomatic adults aged 30-34 years using serology and confirmatory breath testing, achieving 95.7% eradication with quadruple bismuth-based therapy.

The study invited 5,500 individuals with a 24% response rate, higher in women (29.7%) than men (21.7%), and found 14.2% seropositivity in the combined sample.
Seropositivity was higher in immigrants (36%) and those with lower educational attainment (33.3% in 2-year vocational school graduates).
Among patients with positive breath tests, 80.1% initiated eradication therapy with 90.6% adherence, and 95.7% eradication rate among 92 retested patients.
Adverse events were reported by 35.9% of patients, most commonly nausea, diarrhoea and abdominal pain, with women reporting more adverse events than men.
The authors concluded that the serology-plus-breath-test approach showed no evident shortcomings and recommended improved IT integration and public awareness campaigns to increase participation.

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Abstract

Introduction

Helicobacter pylori is class I carcinogen responsible for 89% of non cardia gastric cancer.

Aims & Methods

For the first time in Europe screen and treat application study was implemented in Maribor, Slovenia. The study was conducted by the National Institute for Public Health and Comunity Health Center Maribor. 5500 asymptomatic individuals 30-34 years of age were invited to participate (randomised sample). Additional 769 participants were included (nonrandomised group). The test-and-treat program was free of charge for all eligible participants. Locally validated H. pylori IgG serology and UBT as a confirmatory test were used. Quadruple bismuth based 14 day eradication therapy was the first line therapy. REDCap IT platform (pretreatment questionnaires, treatment protocols, side effects, compliance, complications…) was used to collect data for quality assurance, monitoring, and evaluation.

Results

Response rate to the written postal invitation was 24%; in men 21.7% and 29.7% in women (p<0,001). Gender and age distribution were similar in both study arms. There were in total of 2,105 persons who at minimum conducted a partial interview with the registered nurse. The seropositivity rate was 13,6% in randomised sample, 15,1% in nonrandomised sample and 14,2% in combined sample. Higher seropositivity rates was found in immigrants (36%,) and those participants whose highest finished level of education is a 2-year vocational school (33.3%, P >0,001). The dropout rate of -22.8% was recorded for participants with a positive serology who should continue with a confirmatory UBT. Second highest dropout rate of -19,9% was recorded for participants with a positive UBT result who were referred to treatment (12 pregnant women not included). Among the patients with a positive UBT 80.1% of total and 85.6% of randomised sample, respectively, initiated eradication therapy. Patients’ adherence towards treatment was 90.6%. The rate of reported adverse events was 35.9%, The most frequently reported symptoms were nausea, diarrhoea and abdominal pain. More men reported the absence of adverse events during therapy compared to women (76.5% versus 54.5%, respectively, p= 0.014). The eradication rate for 92 patients who concluded the therapy and were retested by UBT was 95,7%.

Conclusion

The combined use of primary serology testing and confirmatory UBT showed no evident shortcomings. The use of quadruple bismuth-based treatment scheme showed encouraging eradication and adherence rates, whereas the incidence of adverse events due to this therapy was within the acceptable range. Specific software/application should be created and integrated into existing information technology (IT) structures of the primary health care system to digitally support the process of preventive testing and treatment. Education and public awareness campaign to increase the participation rate are of crucial importance.

Conference

UEG Week Berlin 2025

Topics

Stomach & H. Pylori

Submission format

Abstract

Session

H. pylori and gastric cancer (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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LONG-TERM OUTCOMES AND OPTIMAL TREATMENT STRATEGIES AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR T1 COLORECTAL CANCER: A REAL-WORLD MULTICENTER PROSPECTIVE STUDY BY THE HIROSHIMA GI ENDOSCOPY RESEARCH GROUP

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LONG-TERM OUTCOMES AND OPTIMAL TREATMENT STRATEGIES AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR T1 COLORECTAL CANCER: A REAL-WORLD MULTICENTER PROSPECTIVE STUDY BY THE HIROSHIMA GI ENDOSCOPY RESEARCH GROUP

Toshio Kuwai 1, Takuro Hamada 1, Yuki Kamigaichi 1, Koki Nakamura 2, Tomohiro Miwata 3, Seiji Onogawa 4, Hideharu Okanobu 5, Akira Furudoi 6, Shinji Nagata 7, Shigeto Yoshida 8, Masaki Kunihiro 9, Yuko Hiraga 10, Shiro Okamoto 11, Shiro Oka 1

Affiliations

1 Hiroshima University Hospital, Hiroshima, Japan

2 Miyoshi Central Hospital, Miyoshi, Japan

3 Chugoku Rosai Hospital, Kure, Japan

4 Onomichi General Hospital, Onomichi, Japan

5 Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan

6 JA Hiroshima General Hospital, Hatsukaichi, Japan

7 Hiroshima City Asa Citizens Hospital, Hiroshima, Japan

8 NHO Kure Medical Center, Kure, Japan

9 Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan

10 Hiroshima Prefectural Hospital, Hiroshima, Japan

11 Kure Kyosai Hospital, Kure, Japan