Significance of Helicobacter pylori infection and gastric cancer: implications for screening.

Helicobacter pylori infection is a major cause of premature mortality. Methods for diagnosing and treating this infection are now simple and reliable. A screening program to eradicate H. pylori is relatively straightforward to implement and is financially viable. This strategy initially involves a large capital outlay, however, and cannot be recommended until it is proven that H. pylori eradication reduces gastric cancer risk. It is also important to assess the magnitude of benefit of a screening program against the harm that might be engendered in terms of anxiety and adverse events from antibiotic treatment. If screening is beneficial, then in developed countries it could make death from H. pylori infection in the next century as uncommon as mortality from tuberculosis has been in this century.