Advancing Gastric Cancer Prevention in Korea: Current Strategies and Future Directions

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2026-04-07 DOI:10.1111/hel.70121

Jin Young Park, Il Ju Choi

{"title":"Advancing Gastric Cancer Prevention in Korea: Current Strategies and Future Directions","authors":"Jin Young Park, Il Ju Choi","doi":"10.1111/hel.70121","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Korea has historically borne a high burden of gastric cancer, although substantial epidemiological transitions have occurred over recent decades. Gastric cancer was the most common cancer until 2018, but declined to fifth by 2022. Gastric cancer incidence has decreased steadily, accompanied by marked reductions in mortality and substantial improvements in survival, with 5 year overall survival rate now exceeding 75%. During this period, <i>Helicobacter pylori</i> (<i>H. pylori</i>) seroprevalence has shown a decreasing trend, especially in younger generations.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Randomized controlled trials conducted in high-risk groups have demonstrated that <i>H. pylori</i> eradication significantly reduces gastric cancer risk. To further evaluate the role of <i>H. pylori</i> eradication as a primary prevention strategy in the general population, HELPER is currently ongoing in Korea in collaboration with the International Agency for Research on Cancer. For secondary prevention of gastric cancer, the Korean National Cancer Screening Program (KNCSP) was launched in 1999 and provides biennial endoscopic screening for adults aged 40 years or older.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The HELPER study had screened <i>H. pylori</i> status in > 12,000 average-risk Korean participants who had participated in KNCSP up to 2019. Individuals with <i>H. pylori</i> infection were randomized to receive either bismuth quadruple therapy or placebo. The participants have been followed up through the KNCSP, and an interim analysis is planned after a 6 year follow-up period. Secondary prevention through the KNCSP has achieved high participation rates and is strongly associated with reduced gastric cancer mortality, stage migration to early disease, and increased use of endoscopic treatment.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The current uniform screening strategy does not incorporate individual risk stratification and is costly. Future integration of <i>H. pylori</i> eradication and objective assessment of gastric atrophy into risk-adapted screening and surveillance strategies may optimize effectiveness, reduce healthcare costs, and further decrease the burden of gastric cancer in Korea.</p>\n </section>\n </div>","PeriodicalId":13223,"journal":{"name":"Helicobacter","volume":"31 2","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Helicobacter","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hel.70121","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Korea has historically borne a high burden of gastric cancer, although substantial epidemiological transitions have occurred over recent decades. Gastric cancer was the most common cancer until 2018, but declined to fifth by 2022. Gastric cancer incidence has decreased steadily, accompanied by marked reductions in mortality and substantial improvements in survival, with 5 year overall survival rate now exceeding 75%. During this period, Helicobacter pylori (H. pylori) seroprevalence has shown a decreasing trend, especially in younger generations.

Methods

Randomized controlled trials conducted in high-risk groups have demonstrated that H. pylori eradication significantly reduces gastric cancer risk. To further evaluate the role of H. pylori eradication as a primary prevention strategy in the general population, HELPER is currently ongoing in Korea in collaboration with the International Agency for Research on Cancer. For secondary prevention of gastric cancer, the Korean National Cancer Screening Program (KNCSP) was launched in 1999 and provides biennial endoscopic screening for adults aged 40 years or older.

Results

The HELPER study had screened H. pylori status in > 12,000 average-risk Korean participants who had participated in KNCSP up to 2019. Individuals with H. pylori infection were randomized to receive either bismuth quadruple therapy or placebo. The participants have been followed up through the KNCSP, and an interim analysis is planned after a 6 year follow-up period. Secondary prevention through the KNCSP has achieved high participation rates and is strongly associated with reduced gastric cancer mortality, stage migration to early disease, and increased use of endoscopic treatment.

Conclusions

The current uniform screening strategy does not incorporate individual risk stratification and is costly. Future integration of H. pylori eradication and objective assessment of gastric atrophy into risk-adapted screening and surveillance strategies may optimize effectiveness, reduce healthcare costs, and further decrease the burden of gastric cancer in Korea.

查看原文本刊更多论文

推进韩国胃癌预防：当前策略和未来方向。

背景：尽管近几十年来发生了重大的流行病学转变，但韩国历史上一直是胃癌的高负担国家。在2018年之前，胃癌是最常见的癌症，但到2022年降至第五位。胃癌发病率稳步下降，死亡率显著降低，生存率显著提高，5年总生存率超过75%。在此期间，幽门螺杆菌（h.p ylori）血清阳性率呈下降趋势，尤其是在年轻一代。方法：在高危人群中进行的随机对照试验表明，根除幽门螺杆菌可显著降低胃癌风险。为了进一步评估根除幽门螺杆菌作为普通人群一级预防策略的作用，HELPER目前正在韩国与国际癌症研究机构合作进行。为了胃癌的二级预防，从1999年开始实施了对40岁以上的成年人进行两年一次的内窥镜检查的国家癌症检查项目（KNCSP）。结果：HELPER研究筛查了截至2019年参加KNCSP的bb1012,000名平均风险韩国参与者的幽门螺杆菌状态。幽门螺杆菌感染患者随机接受四联铋治疗或安慰剂。通过KNCSP对参与者进行了随访，并计划在6年随访期后进行中期分析。通过KNCSP进行的二级预防取得了很高的参与率，并与降低胃癌死亡率、阶段向早期疾病转移和增加内窥镜治疗的使用密切相关。结论：目前的统一筛查策略没有纳入个体风险分层，而且成本高昂。未来将幽门螺杆菌根除和胃萎缩的客观评估纳入风险适应筛查和监测策略，可能会优化效果，降低医疗成本，并进一步减轻韩国胃癌的负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.