The Lancet: H. pylori is the biggest bane of gastric cancer in China, remember these 3 points to completely sterilize it

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When you see "positive for H. pylori" on a medical checkup, many people are very frightened because H. pylori infection is often associated with gastric cancer, and the WHO has classified it as a class I carcinogen.

So does H. pylori infection necessarily lead to cancer? Who is vulnerable to infection? What can we do to prevent and treat it?

H. pylori infection is actually very close to all of us. 2023, data from the CDC's white paper "Prevention and Control of H. pylori Infection in China" showed that the prevalence of H. pylori infection in China is as high as 50%, with rates ranging from 35.4% to 66.4% in different populations.

While H. pylori infection ≠ 100% cancer, the chances of causing cancer are indeed relatively high. 2021 Lancet study has pointed out that H. pylori infection is the leading cause of gastric cancer in adults. In the data of nearly 1,000 cases, about 62.1% of cardia gastric cancer and 78.5% of non-cardia gastric cancer cases were caused by H. pylori.

So, how exactly does the harmful H. pylori break down our bodies step by step?

As a micro-anaerobic bacterium, H. pylori is so viable that it not only escapes the corrosive effects of stomach acid, but is also a catalyst for intestinal gastric cancer.

Enterotropic gastric cancer is the most common of all types of gastric cancer, and there are usually only 5 steps to progress from a normal stomach to this type of gastric cancer:

And H. pylori is actively involved in the entire process of gastric carcinogenesis, both by causing chronic active gastritis and by promoting gastric mucosal atrophy and intestinal metaplasia.

More specifically, the mechanism of H. pylori carcinogenesis is through its own virulence factors that alter multiple signaling pathways in the gastric epithelium, weakening the stomach's ability to protect itself while causing genetic mutations in normal cells to form tumors.

In addition to carcinogenicity, we need to be alert to the infectious nature of H. pylori.

H. pylori is usually transmitted in 2 ways:

This is the main mode of H. pylori infection, with family meals being a high risk factor. If a family member is infected and does not use communal chopsticks at meals, then others may be infected as well.

In 2021, an epidemiological survey of H. pylori infection in 29 provinces showed that the overall household infection rate in China was as high as 71%, significantly higher than the individual infection rate.

In addition, adults feeding infants and children by chewing food and couples kissing are also prone to infection.

Eating food that is contaminated with unclean stool can cause the person who eats it to become ill. Also, not washing your hands after going to the bathroom can give H. pylori a chance to get infected.

While H. pylori is scary, we can reduce the rate of infection through proactive intervention. The Expert Consensus Opinion on H. pylori Eradication and Gastric Cancer Prevention and Control in China states that H. pylori eradication can greatly reduce the risk of gastric cancer and effectively prevent it.

People with H. pylori infection do not show symptoms initially, and when it progresses to chronic gastritis, they often experience digestive symptoms such as upper abdominal pain, nausea, belching, and fullness. When these signs are present, it is important to seek medical examination and treatment.

The carbon 13 and carbon 14 urea breath tests are generally used to detect the presence of H. pylori infection as follows:

After taking a certain dose of isotopically labeled urea orally, the presence or absence of H. pylori infection can be determined by measuring the change in the isotopic carbon 13 or carbon 14 labeled carbon dioxide in their exhaled gas.

The bismuth quadruple regimen (proton pump inhibitor (PPI) + bismuth + 2 antibacterial drugs), which is currently the main treatment regimen for H. pylori eradication nationwide, can have an eradication rate of up to 90%. According to the Chinese Journal of Gastroenterology, eradication therapy is recommended for people who meet the following indications

But eradication therapy is not recommended for the following 4 groups because the risks of treatment may outweigh the benefits.

Overall, H. pylori infection does not necessarily cause gastric cancer, and the likelihood of recovery is higher with proactive intervention and timely treatment. Also to prevent stomach cancer, you need to develop good lifestyle habits: quit smoking and drinking, low-salt diet, scientific exercise, and regular medical checkups.