A screen-and-treat strategy for eradication of Helicobacter pylori among patients with family history of gastric cancer in a diverse U.S. population.

Background: Screening and eradication of Helicobacter pylori (H. pylori) reduce the risk of gastric cancer in patients with family history. We assessed patient perspectives on H. pylori screening and treatment within a diverse regional U.S.

Population:

Methods: Between July and August 2022, we conducted a cross-sectional study among patients with ≥1 first-degree relative with gastric cancer. Eligible patients were between 18-75 years of age without history of H. pylori infection or gastric cancer. A survey assessed interest in testing and willingness to complete treatment for H. pylori. Interested patients were offered H. pylori testing and treatment. We examined interest and effectiveness of treatment by race and ethnicity.

Results: We identified 15,255 eligible patients and 1,500 patients were randomly selected for the survey; 280 (19%) patients, including 2 relatives not initially invited but asked to participate, responded following outreach. Respondents were 65% male and averaged 57 years (SD=13) with 36% Hispanic, 36% non-Hispanic White, 15% Asian/Pacific Islander, 9% non-Hispanic Black. Overall, 223 (80%) were interested in H. pylori screening; of these, 89% would take antibiotics as prescribed. Willingness to screen was consistent across racial and ethnic groups. Among 223 respondents interested in screening, 128 (57%) completed testing with 15 screen-detected cases; all 15 completed treatment and 11 had confirmed eradication.

Conclusions: Patients with family history of gastric cancer had a high level of interest in H. pylori screening and successful eradication when detected.

Impact: A screen-and-treat strategy for H. pylori may be considered for patients with family history of gastric cancer.