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Experts' Perceptions Regarding Testing for Helicobacter pylori Infection During Upper Gastrointestinal Endoscopy and

Ilsoo Kim1, Sang Pyo Lee2, Jeong Wook Kim3

  • 1Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

The Korean Journal of Helicobacter and Upper Gastrointestinal Research
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Summary

Helicobacter pylori (H. pylori) testing and treatment practices vary among Korean experts due to conflicting guidelines and reimbursement criteria. Aligning these policies is crucial for consistent patient care and reducing gastric cancer risk.

Keywords:
EndoscopyHelicobacter pyloriInsurance coveragePractice patterns, physicians’

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Public Health Policy

Background:

  • Helicobacter pylori infection is a major cause of gastric cancer and peptic ulcers.
  • Eradication therapy for H. pylori can significantly reduce gastric cancer incidence in high-risk populations.
  • Discrepancies between Korean reimbursement criteria and clinical guidelines pose challenges for H. pylori management.

Purpose of the Study:

  • To investigate expert perceptions and practices regarding H. pylori testing during upper gastrointestinal endoscopy.
  • To assess H. pylori eradication therapy decisions among Korean gastroenterologists.
  • To identify factors influencing H. pylori diagnostic and treatment strategies in clinical practice.

Main Methods:

  • An anonymous 8-question survey was administered to 51 experts at the 2024 Korean College of Helicobacter and Upper Gastrointestinal Research Summer Workshop.
  • The survey explored H. pylori testing rates across various clinical indications and factors influencing treatment decisions.
  • Data analysis focused on identifying variations in practice based on patient conditions and reimbursement eligibility.

Main Results:

  • Only 2% of experts tested all patients for H. pylori.
  • Testing rates varied: 54% for family history of gastric cancer, 32% for atrophic gastritis, 42% for dyspeptic symptoms, and 62% for iron-deficiency anemia.
  • 82% of patients with suspected H. pylori infection eligible for selective reimbursement underwent testing; expert decisions were influenced by clinical factors and economic burden, not solely age.

Conclusions:

  • Expert practices for H. pylori testing and eradication therapy are inconsistent, influenced by patient-specific factors and economic considerations.
  • The misalignment between clinical guidelines and reimbursement criteria creates confusion and impacts patient care.
  • Recommendations include aligning reimbursement policies with established clinical guidelines to ensure standardized and appropriate H. pylori management.