A real-world workplace-based screening for Helicobacter pylori infection: the HPOS study

OBJECTIVES: Helicobacter pylori (H.pylori) eradication contributes to gastric cancer (GC) prevention, yet many subjects are unaware of their infection status. We implemented a workplace-based H.pylori screening. DESIGN: We implemented a cross-sectional screening with short-term follow-up among hospital workers (HWs), enrolled during occupational health surveillance (OHS). A stool antigen test (SAT) was adopted for H.pylori diagnosis. H.pylori-positive HWs were referred to their general practitioner (GP) or a gastroenterologist and were followed up at three months. Participation, prevalence of infection, participants' experience, and treatment rates were investigated through descriptive and multivariable analyses. SETTING: The study was carried out between 2023 and 2025 at S.Orsola University Hospital in Bologna, Italy. PARTICIPANTS: The study targeted HWs aged 40-65 employed at S.Orsola University Hospital. RESULTS: Of 744 eligible HWs contacted, 550 were enrolled (73.9%), including 399 through OHS and 151 volunteers; the largest proportion of participants were women (74.7%) and nurses (40.2%). Dropout rate was 15.5% (n = 115), leaving 435 HWs with a SAT result. H.pylori prevalence was 16.6%. Men were less likely to participate than women (OR = 0.68, 95% CI = 0.47-0.99). Education was negatively associated with H. pylori infection (OR = 0.41, 95% CI = 0.18-0.93 for the highest educational level vs the lowest). No specific pattern was observed in relation to contact with a physician and treatment prescription. 58/72 H. pylori-positive HWs (80.6%) contacted a physician, 53 (73.6%) being prescribed a treatment and 13 (18.1%) undergoing upper endoscopy. Confirmatory test rate after treatment was suboptimal, while eradication rate was 97.3% when considering those with confirmatory test result (36/37 HWs). Across followed up HWs, the average quality of experience was 8.9/10; 13 had a family member tested following this intervention. CONCLUSIONS: The intervention integrated into OHS was well received and extended to family members of the participants, suggesting that a workplace-based H.pylori screening might contribute to GC prevention. Replications in other workplaces are warranted.