Screening and eradication of or gastric cancer prevention: Taipei Global Consensus II.
Journal
Gut
Journal Volume
74
Journal Issue
11
Pages
1767 - 1791
ISSN
1468-3288
Date Issued
2025-10-08
Author(s)
Liou, Jyh-Ming
Malfertheiner, Peter
Cheng, Hsiu-Chi
Sugano, Kentaro
Shah, Shailja
Sheu, Bor-Shyang
Chen, Yi-Chu
Chen, Mei-Jyh
Yamaoka, Yoshio
Wong, Sunny H
Lee, Yeong Yeh
Quach, Duc Trong
Wu, Deng-Chyang
Hsu, Ping-I
Wu, Chun-Ying
Wu, Jeng-Yih
Luo, Jiing-Chyuan
Chang, Wei-Lun
Lu, Hong
Suzuki, Hidekazu
Jung, Hwoon-Yong
Mahachai, Varocha
Vilaichone, Ratha-Korn
Mégraud, Francis
Lin, Jaw-Town
Yeoh, Khay-Guan
Leung, Wai Keung
El-Omar, Emad M
Abstract
Objective To convene a global consensus on Helicobacter pylori (H pylori) screening and eradication strategies for gastric cancer prevention, identify key knowledge gaps and outline future research directions. Methods 32 experts from 12 countries developed and refined consensus statements on H pylori management, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to assess evidence and the Delphi method to achieve ≥80% agreement. Results Consensus was achieved on 28 statements. Eradication of H pylori, the primary cause of gastric cancer, reduces the risk of gastric cancer across all age groups, with the greatest risk reduction before the onset of premalignant conditions. H pylori eradication also promotes ulcer healing, prevents ulcer recurrence and reduces the risk of NSAID/aspirin related ulcers. H pylori transmission primarily occurs within families, making family based approaches promising for reducing spread and improving treatment outcomes. H pylori screening should prioritise high risk populations. 13 C-urea breath test or monoclonal stool antigen tests are preferred. Validated serological testing is a feasible alternative in low prevalence settings when followed by confirmatory non-serological testing. Integrating H pylori screening into existing health programmes may optimise patient adherence and resource utilisation. Empiric eradication treatment, especially bismuth quadruple therapy, is recommended in regions with high H pylori antibiotic resistance for conventional antibiotics. Potassium competitive acid blocker based regimens are alternatives. Confirmatory testing is strongly recommended to ensure H pylori eradication. Endoscopy is suggested for H pylori infected individuals with a high risk of gastric cancer and/or alarm features. H pylori eradication does not increase the risk of reflux oesophageal adenocarcinoma. Long term disruptions to the microbiota and resistome, as well as the environmental impact of increased antibiotic use, warrant further investigation. The development of an H pylori vaccine remains an unmet need, as does the establishment of a risk stratified approach informed by advanced genetic research. Conclusion H pylori eradication is an effective prevention strategy for gastric cancer that should be offered to all infected adult individuals. Future research should prioritise determining the optimal timing for screening, evaluating long term individual and population outcomes, as well as identifying more precise risk stratification parameters. © Author(s) (or their employer(s)) 2025.
Subjects
GASTRIC CANCER
HELICOBACTER PYLORI
HELICOBACTER PYLORI - TREATMENT
SCREENING
SDGs
Type
journal article