EUROHELICAN—The first helicobacter pylori screen-and-treat population-based study in young adults in Europe

Background Most gastric cancer cases are attributable to chronic Helicobacter pylori (H. pylori) infection and can theoretically be prevented. Objective In the EUROHELICAN project, we aimed to assess the feasibility, acceptability, effectiveness, and adverse events of a Helicobacter pylori screen-and-treat program in the 30–34-year age group for the first time in Europe. Design The study was conducted in the Community Healthcare Center dr. Adolf Drolc Maribor, following the methodology prepared by the National Institute of Public Health. We invited asymptomatic individuals aged 30–34 to be tested for H. pylori IgG antibodies; positive results were confirmed by urea breath test (UBT). Results 2102 participants accepted the invitation. The response rate was 24.4% (95% CI: 23.2–25.5), which was higher in women—28.1% (95% CI: 26.4–29.8) than in men—20.5% (95% CI: 0.19.0–22.1, p < 0.001). The serological prevalence of H. pylori infection was 14.2% (95% CI: 12.7–15.9). A confirmatory urea breath test (UBT) was positive in 83.7% of serology-positive patients. The eradication rate of 14-day bismuth-based quadruple therapy (esomeprazole 40 mg BID, amoxicillin 500 mg, metronidazole 400 mg and bismuth oxide 120 mg, all QID) was 94.7% (95% CI: 89.5–97.9). Adverse events (AEs) during treatment were reported more frequently in women (38.8%, 95% CI: 28.1–50.3) than in men (21.5%, 95% CI: 12.3–33.5; p < 0.05). Conclusion H. pylori screening and-treat program in 30–34 age group in Slovenia is feasible; H. pylori treatment is very effective with acceptable rate of AEs. Different approaches to raising public awareness are needed to increase participation rates.