Test for Helicobacter pylori and eradicate it if positive
In a trial from Linqu, Shandong, followed for 22 years, H. pylori eradication treatment roughly halved stomach cancer incidence and cut stomach cancer deaths by about 40%. Testing costs roughly one or two hundred renminbi, and treatment takes two weeks.
What it takes
In China, a carbon-13 or carbon-14 breath test costs RMB 100–200. A two-week course of four medicines costs RMB 200–500. The challenge is taking every dose on schedule for the full two weeks.
What you may gain
The randomized Linqu trial's 22-year follow-up found about half the risk of stomach cancer after eradication treatment: OR 0.48, 95% CI 0.32–0.71. Stomach cancer mortality was about 38% lower: HR 0.62, 95% CI 0.39–0.99.
Context & considerations
Reinfection remains possible after eradication, so the source recommends testing and treating household members together. This trial involved residents of an area with high stomach cancer incidence; absolute benefits will be much smaller in low-incidence areas.
Research & references
Li WQ et al. (2019). Effects of Helicobacter pylori treatment and vitamin and garlic supplementation on gastric cancer incidence and mortality: follow-up of a randomized intervention trial. BMJ. https://doi.org/10.1136/bmj.l5016