{
  "abstract": "Objective To convene a global consensus on Helicobacter pylori (H pylori) screening and eradication strategies for gastric cancer prevention, identify key knowledge gaps and outline future research directions.Methods 32 experts from 12 countries developed and refined consensus statements on H pylori management, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to assess evidence and the Delphi method to achieve ≥80% agreement.Results Consensus was achieved on 28 statements. Eradication of H pylori, the primary cause of gastric cancer, reduces the risk of gastric cancer across all age groups, with the greatest risk reduction before the onset of premalignant conditions. H pylori eradication also promotes ulcer healing, prevents ulcer recurrence and reduces the risk of NSAID/aspirin related ulcers. H pylori transmission primarily occurs within families, making family based approaches promising for reducing spread and improving treatment outcomes. H pylori screening should prioritise high risk populations. 13C-urea breath test or monoclonal stool antigen tests are preferred. Validated serological testing is a feasible alternative in low prevalence settings when followed by confirmatory non-serological testing. Integrating H pylori screening into existing health programmes may optimise patient adherence and resource utilisation. Empiric eradication treatment, especially bismuth quadruple therapy, is recommended in regions with high H pylori antibiotic resistance for conventional antibiotics. Potassium competitive acid blocker based regimens are alternatives. Confirmatory testing is strongly recommended to ensure H pylori eradication. Endoscopy is suggested for H pylori infected individuals with a high risk of gastric cancer and/or alarm features. H pylori eradication does not increase the risk of reflux oesophageal adenocarcinoma. Long term disruptions to the microbiota and resistome, as well as the environmental impact of increased antibiotic use, warrant further investigation. The development of an H pylori vaccine remains an unmet need, as does the establishment of a risk stratified approach informed by advanced genetic research.Conclusion H pylori eradication is an effective prevention strategy for gastric cancer that should be offered to all infected adult individuals. Future research should prioritise determining the optimal timing for screening, evaluating long term individual and population outcomes, as well as identifying more precise risk stratification parameters.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan",
        "Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan",
        "Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"
      ],
      "name": "Jyh-Ming Liou"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Magdeburg, Magdeburg, Germany",
        "Medical Clinic II, Medical Clinic II, Ludwig Maximilian University Hospital, Munchen, Germany"
      ],
      "name": "Peter Malfertheiner"
    },
    {
      "affiliations": [
        "Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan",
        "Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"
      ],
      "name": "Tzu-Chan Hong"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan",
        "Institute of Clinical Medicine and Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan"
      ],
      "name": "Hsiu-Chi Cheng"
    },
    {
      "affiliations": [
        "Department of Medicine, Jichi Medical University, Tochigi, Japan"
      ],
      "name": "Kentaro Sugano"
    },
    {
      "affiliations": [
        "Gastroenterology, University of California, San Diego",
        "Veterans Affairs San Diego Healthcare System, San Diego, California, USA"
      ],
      "name": "Shailja Shah"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan"
      ],
      "name": "Bor-Shyang Sheu"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan",
        "Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"
      ],
      "name": "Mei-Jyh Chen"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan",
        "Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"
      ],
      "name": "Tsung-Hsien Chiang"
    },
    {
      "affiliations": [
        "Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan"
      ],
      "name": "Yi-Chu Chen"
    },
    {
      "affiliations": [
        "Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan"
      ],
      "name": "Yoshio Yamaoka"
    },
    {
      "affiliations": [
        "Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore"
      ],
      "name": "Sunny H Wong"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan",
        "Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"
      ],
      "name": "Chieh-Chang Chen"
    },
    {
      "affiliations": [
        "School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia"
      ],
      "name": "Yeong Yeh Lee"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam"
      ],
      "name": "Duc Trong Quach"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan"
      ],
      "name": "Deng-chyang Wu"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Department of Internal Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan"
      ],
      "name": "Ping-I Hsu"
    },
    {
      "affiliations": [
        "Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan",
        "Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan"
      ],
      "name": "Chun-Ying Wu"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan"
      ],
      "name": "Jeng-Yih Wu"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan"
      ],
      "name": "Jiing-Chyuan Luo"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan"
      ],
      "name": "Wei-Lun Chang"
    },
    {
      "affiliations": [
        "GI Division, Shanghai Jiao-Tong University School of Medicine Renji Hospital Shanghai Institution of Digestive Disease, Shanghai, China"
      ],
      "name": "Hong Lu"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine Graduate School of Medicine, Isehara, Kanagawa, Japan"
      ],
      "name": "Hidekazu Suzuki"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, University of Ulsan College of Medicine, Songpa-gu, Korea (the Republic of)"
      ],
      "name": "Hwoon-Yong Jung"
    },
    {
      "affiliations": [
        "Center of Excellence in Digestive Diseases, Gastroenterology Unit, Department of Medicine and Thailand Science Research and Innovation Fundamental Fund 2025, Thammasat University, Bangkok, Thailand"
      ],
      "name": "Varocha Mahachai"
    },
    {
      "affiliations": [
        "Center of Excellence in Digestive Diseases, Gastroenterology Unit, Department of Medicine and Thailand Science Research and Innovation Fundamental Fund 2025, Thammasat University, Bangkok, Thailand"
      ],
      "name": "Ratha-korn Vilaichone"
    },
    {
      "affiliations": [
        "INSERM U1312 BRIC, University of Bordeaux, Bordeaux, France"
      ],
      "name": "Francis Mégraud"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan",
        "Department of Internal Medicine, E-DA Hospital and I-Shou University, Kaohsiung, Taiwan"
      ],
      "name": "Jaw-Town Lin"
    },
    {
      "affiliations": [
        "Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore"
      ],
      "name": "Khay-Guan Yeoh"
    },
    {
      "affiliations": [
        "Medicine, University of Hong Kong, Hong Kong, People's Republic of China"
      ],
      "name": "Wai Keung Leung"
    },
    {
      "affiliations": [
        "Microbiome Research Centre, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Emad M El-Omar"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan",
        "Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"
      ],
      "name": "Yi-Chia Lee"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan",
        "Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan"
      ],
      "name": "Ming-Shiang Wu"
    },
    {
      "affiliations": [],
      "name": "Asian Pacific Alliance on Helicobacter and Microbiota (APAHAM)"
    }
  ],
  "title": "Screening and eradication of Helicobacter pylori for gastric cancer prevention: Taipei Global Consensus II",
  "uid": "6ab0f129-ad9c-5cf7-a32f-3178281b92a4"
}