Helicobacter pylori infection and gastric cancer: usefulness of screening high risk groups.

The presence of Helicobacter pylori is associated with approximately an 8 fold increase risk of developing gastric cancer. Helicobacter pylori is easy to diagnose non-invasively and effectively treated with antibiotics. More research into the natural history of Helicobacter pylori associated premalignant lesions, e.g. the reversibility of types 1 and 2 intestinal metaplasia, is necessary before a screening strategy can be developed. It also remains to be seen whether specific strains of H. pylori are associated with gastric cancer and whether differences in the host response to Helicobacter pylori infection affect the clinical outcome. When these issues are clarified it will be possible to identify individuals who are at high risk of developing gastric cancer and who will benefit from eradication. It is inevitable that asymptomatic individuals at high risk will be screened for the presence of Helicobacter pylori infection.