The importance of Helicobacter pylori eradication: a narrative review

Background: is a gram-negative bacterium infecting over 40% of the global population, with highest prevalence in low- and middle-income regions. Chronic infection leads to persistent gastritis and can result in peptic ulcer disease, dyspepsia and gastric adenocarcinoma. Despite its high pathogenic potential, population-based screening and eradication programmes remain limited, particularly in Europe. Methods: infection, consequences and screening approaches. Results: prevalence, peptic ulceration, and gastric cancer incidence. Current international guidelines, including the Maastricht VI/Florence and 2025 Taipei Global Consensus reports, now recommend universal eradication of confirmed infections and support population-level or family-based screening in high-risk regions. Ongoing European pilot studies, including the TOGAS initiative, aim to inform the implementation of gastric cancer screening programs. Concerns regarding antibiotic resistance remain, though recent evidence suggests that the risks are manageable with appropriate antibiotic stewardship. Conclusion: screen-and-treat strategies represent a cost-effective and evidence-based approach to preventing gastric cancer. Further large-scale European studies are warranted to guide optimal implementation, timing, and cost-effectiveness of such programs.