What European Helicobacter Study Group guidelines for H pylori eradication to prevent gastric cancer?

Updated: Feb 23, 2021
  • Author: Elwyn C Cabebe, MD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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The 2012 European Helicobacter Study Group guidelines note that there is strong evidence that H pylori eradication reduces the risk of gastric cancer, and that the risk of gastric cancer can be reduced more effectively by eradication before the development of preneoplastic conditions. The guidelines recommend that H pylori eradication to prevent gastric cancer be considered in the following [69] :

  • First-degree relatives of family members with a diagnosis of gastric cancer
  • Individuals with previously treated gastric neoplasia
  • Individuals with severe pan-gastritis, corpus-predominant gastritis, or severe atrophy
  • Individuals with chronic gastric acid inhibition for more than 1 year
  • Individuals with other environmental risk factors for gastric cancer (eg, heavy smoking; high exposure to dust, coal, quartz, cement; work in quarries) 

The guidelines recommend that antibiotic combination treatment be chosen according to local H pylori antibiotic resistance patterns. Endoscopic follow-up is recommended for the following preneoplastic high-risk conditions [69] :

  • Pernicious anemia with histological confirmation of type A autoimmune atrophic gastritis
  • Histological and/or serological signs of subtotal or total atrophic gastritis with hypo- or achlorhydria
  • Gastric adenoma

Recommended follow-up intervals are as follows [68] :

  • Patients with moderate to severe atrophy: Every 2–3 years
  • Patients with dysplasia: Every 3–6 months

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