Author/Editor		Tepeš, Bojan
Title		Population based Helicobacter pylori screening and eradication
Type		članek
Vol. and No.		Letnik 20, št. 28
Publication year		2014
Volume		str. 4501-4509
ISSN		1381-6128 - Current pharmaceutical design
Language		eng
Abstract		Gastric cancer is the fourth most common cancer in the world and second most common reason for cancer related death. Projections for the future predict that gastric cancer incidence will continue to rise. Risk factors for gastric cancer are Helicobacter pylori(H pylori) infection, host genetic factors and environmental factors. H pylori is a class I carcinogen and responsible for 60 % - 80 % of allgastric cancers of intestinal and diffuse type, as well as gastric MALT lymphoma. From animal and intervention studies we know that premalignant gastric lesions development and gastric cancer can be prevented withearly H pylori eradication. In countries with gastric cancer incidence higher than 20 / 100 000 per year national screening for H pylori infectionand eradication of all H pylori infections should be performed. Type of eradication therapy depends on local antimicrobial resistancerates. Quadruple bismuth or non- bismuth therapies can achive more than 90 % eradication rate. The success of eradication therapymust be controlled with noninvasive test. Patients with extensive preneoplastic changes (atrophy, intestinal metaplasia) should have endoscopic and histologic controls. Endoscopicscreening should be performed in intervals according to the risk stratification by OLGA / OLGIM staging system or A-D stagingsystem. In countries with high gastric cancer incidence national screening with serological tests for pepsinogen I (PGI), PGI/PGII ratio and H pyloriantibodies can select patients at higher risk for gastric cancer.
Keywords		Helicobacter pylori gastric cancer population based screening endoscopic surveillance therapy bolezni prebavil rak (medicina) raziskave terapije